临床资料患者男性,63岁。因“咳嗽、咳痰、胸痛、间断发热20+d”于2014年4月9日收治我科。既往陈旧性肺结核病史,未治。偶有血压升高,未系统治疗。患者于2014年3月20日无明显诱因出现干咳,未予重视,25日咳嗽加重,咳少量白粘痰,伴有左侧胸痛、胸闷、气短、畏寒并间断发热,至当地医院门诊“抗炎”治疗3 d,未见好转并有加重趋势。于3月28日至当地县医院查血常规提示白细胞计数、中性粒细胞百分比升高,肺炎衣原体抗体、支原体抗体Ig M(-)。胸部X线片示双肺斑片状阴影,肺气肿。考虑肺部感染,予以头孢类药物抗炎治疗(具体不详)。期间仍间断出现午后发热,体 Clinical data Male patient, 63 years old. Due to “cough, sputum, chest pain, intermittent fever 20 + d ” on April 9, 2014 admitted to my department. Past history of old tuberculosis, not rule. Occasional elevated blood pressure, no systematic treatment. Patients on March 20, 2014 no obvious incentive to appear dry cough, not attention, 25, increased cough, cough and a small amount of white phlegm, accompanied by left chest pain, chest tightness, shortness of breath, chills and intermittent fever, to the local hospital outpatient “Anti-inflammatory” treatment 3 d, no improvement and increase the trend. On March 28 to the local county hospital blood routine examination prompted leukocyte count, the percentage of neutrophils increased, Chlamydia pneumoniae antibody, mycoplasma antibody Ig M (-). Chest X-ray showed double lung patchy shadow, emphysema. Consider pulmonary infection, to cephalosporins anti-inflammatory treatment (specifically unknown). During the afternoon there is still intermittent fever, body