A 33 year-old female was admitted to our hospital because of “cough and sputum for 6 months”.

The patient had cough with yellowish sputum 6 months ago without any causes. The amount of sputum was not very large, about 4-5 times/day. The sputum was not fetid. She had no hemoptysis, dyspnea, fever and skin rash. Slight right chest pain could be felt at that time. She didn’t pay attention to it. Nine days ago, “lung shadow in the right lower lung” was found in her CT scan. She was diagnosed as “Lung abscess” in the local hospital and was treated with metronidazole and cephalosporin for 7 days. The sputum turned to white and the chest pain disappeared. She was admitted to our hospital for further diagnosis and treatment. She had no nausea, vomiting, night sweats, weight lose and skin rash. Her sleep and appetite were normal. Her stool and urine were normal too.

There was nothing abnormal in the case history review. She had no history of drug allergy.

Personal history and family history were nothing special.

Physical Examination：T36.0℃, P80/min, R18/min, BP110/80mmHg. The patient was well developed and moderately nourished. She was mentally normal and cooperative in the examination. There was no rash, jaundice and purpura on the skin, and the lymphnodes were not palpable. Her head, eyes, nose, ears and mouth were normal. The neck was soft, and no venous engorgement. Thyroid glands were not palpable. The trachea was in midline. The chest and respiratory movements were symmetrical. There were some crackles at the base of the right lung. The heart rate was 80/min, regular. No pathological heart murmur. P₂>A_2. No pericardium friction sound was heard. Abdominal wall was soft without tenderness. The liver and the spleen were not palpable, and there was no shifting dull ness. No edema in her lower extremities.

Laboratory tests:

Blood routine test: WBC 8.1×10⁹/L, N 70.2%, Hgb 129g/L, Plt 192×10⁹/L

Urine routine test: normal

B-Ultrosound: No abnormal was found in her abdomen.

Questions:

1. What is the diagnosis for this case?

2. What other disease would you distinguish with?