Royal J. Eaton, MD, Assistant Attending Physician, Jewish Hospital of St Louis: A 54-year-old woman was admitted to the hospital because of pneumonia. The day before admission, she came to the emergency room complaining of sore throat and myalgia. Examination was unremarkable except for erythema of the pharynx and left tympanic membrane. A diagnosis of otitis media was made, and she was treated with erythromycin. The next day she returned, complaining of fever, sore throat, nasal congestion, dyspnea, and a cough productive of yellow sputum. Physical examination findings were unchanged except for the presence of inspiratory crackles throughout both lung fields. Chest roentgenogram showed infiltrates in both lower lobes and the right upper lobe, and she was admitted to the hospital. The hematocrit reading was 32%; WBC count, 2,500/cu mm, with 27% neutrophils, 24% band forms, 30% lymphocytes, and 19% monocytes; Pao2, 44 mm Hg; Paco2, 32 mm