临床资料患者女性,49岁,因干咳2周,加重伴发热、呼吸困难3 d 于2006年7月24日入院。患者入院前2周无明显诱因出现干咳,因症状不严重故未就诊。3 d前出现咳嗽、发热、体温38.6℃,曾在外院门诊初步诊断为上呼吸道感染,给予青霉素每日800万单位静脉滴注3 d 无效,1 d 前患者咳嗽加重伴呼吸困难来我院就诊。患者发病以来无盗汗、咯血、胸痛。既往有溃疡性结肠炎史5年,无吸烟及药物过敏史。体检:体温38.5℃,呼吸26次/min,急病面容,未见皮疹和皮下结节,全身浅表淋巴结无肿大。口唇无发绀,气管左移,左侧呼吸运动和触觉语颤减弱,叩诊呈实音,呼吸音消失,右 Clinical data Patients Female, 49 years old, due to dry cough 2 weeks, increased with fever, difficulty breathing 3 d on July 24, 2006 admission. 2 weeks before admission, there was no obvious incentive for dry cough, so the symptoms were not serious, so no treatment. 3 days before the onset of cough, fever, body temperature 38.6 ℃, had a preliminary diagnosis in the outpatient outpatient upper respiratory tract infection, given penicillin 8 million daily intravenous infusion of 3 million invalid 1 day before the patient with increased cough and difficulty breathing to our hospital . Since the onset of the patient no night sweats, hemoptysis, chest pain. Past history of ulcerative colitis 5 years, no history of smoking and drug allergy. Physical examination: body temperature 38.5 ℃, breathing 26 times / min, sudden illness face, no rash and subcutaneous nodules, systemic superficial lymph nodes without swelling. Lips cyanosis, left trachea, left respiratory movement and tactile vocal weakness, percussion showed a solid tone, breath sounds disappear, right