女,67岁。因畏寒,发热,不出汗,伴头顶、右胸、两腹股沟及下腰背痛,咳嗽、气促,咯白泡沫痰1天入院。曾患慢性支气管炎。易感冒。吸烟数十年。无肺结核史。有青霉素过敏史。体查:体温38.81℃,脉搏112次,呼吸23次,血压16.8/10.4kPa。急病容。两侧腹股沟有多个黄豆大淋巴结,质 Female, 67 years old. Because of chills, fever, no sweating, with the top of the head, right chest, two groin and lower back pain, cough, shortness of breath, slightly white foam sputum admission one day. Had chronic bronchitis. Easily cold. Smoking for decades. No history of pulmonary tuberculosis. Have a history of penicillin allergy. Physical examination: body temperature 38.81 ℃, pulse 112 times, breathing 23 times, blood pressure 16.8 / 10.4kPa. Sickness. On both sides of the groin has multiple large soybean nodes, quality