Cough, chest pain

A 44-year-old woman was admitted to our hospital in July 2019 due to cough, sputum production, and chest pain lasting for 1 week. Chest computed tomography showed pulmonary infection, bilateral pleural effusions, and left pleural hypertrophy. The initial complete blood count revealed: white blood cell (WBC) count 21.5 × 109/L (22.7% monocytes, 65% neutrophils, 8.1% lymphocytes), haemoglobin 132 g/L, and platelet 233 × 109/L. C-reactive protein level was 13.1 mg/L (0–10 mg/L). The patient received antibiotics; however, her clinical symptoms did not improve, and the WBC count increased to 22.3 × 109/L with 26.9% monocytes, while no blasts were observed. The pleural effusion was bloody.