The patient was a male, 38 years old. He was admitted to the hospital mainly because of “cough, coughing sputum, tight breath with fever for 5 days”. Diagnosis: 1, acute hematogenous pulmonary tuberculosis, coated with (-) primary treatment 2, with bilateral pleural effusion 3, right spontaneous pneumothorax 4, pulmonary infection 5, type I respiratory failure 6, syphilis 7, drug-related liver damage The patient developed a high fever with no obvious cause 5 days before admission, with a maximum temperature of 39.4℃, accompanied by coughing and coughing of yellow mucous sputum, which was not easy to cough up. He was not suffering from chest pain or hemoptysis, but had dyspnea, which was aggravated by activity. The patient was considered to have “spontaneous pneumothorax” and was treated with closed chest drainage, and was transferred to the Armed Police Hospital after the dyspnea was relieved. The respiratory distress was obvious before admission, and could not be relieved by oxygen inhalation. So he was transferred to our hospital for treatment. The patient was in good health and had a history of smoking for 20 years, one pack per two days. After admission, the patient presented with shortness of breath 48 times/min, coarse breath sounds in both lungs, not heard wet stalls trick zhu zhu even case trespass mu 134 times/min, no murmur, no positive abdominal signs, and no swelling of both lower limbs. After admission, the patient was immediately treated with non-invasive ventilator assisted breathing, anti-TB (HRZE), liver protection, cough and sputum, nutritional support, and continuous closed chest drainage. On June 3, the patient was successfully discharged from the ventilator and switched to venturi mask oxygenation, and the closed chest drainage tube was removed, after which his condition gradually improved. On June 18, the patient showed liver function abnormalities of ALT399.6U/L and AST383.7U/L. He was immediately given intensive liver protection and stopped all drugs that might cause liver function damage. On June 21, the liver function improved compared with the previous one. The patient requested to be discharged to the local hospital for further treatment.