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病例1:患者,男性,25岁,2天前淋雨受凉后突然寒战高热,体温达39. 6°C,以午后和夜间为重, 咳嗽、胸痛、咳铁锈色痰,且逐渐加重。今日上午气促,烦躁,四肢厥冷,出冷汗,急诊人院。查体:T39.6°C,P 120次/分,R 32次/分,BP 70/40mmHg。神志模糊,烦躁不安,口唇发绀,右肺下野叩诊浊音,语颤增强,右下肺可听到支气管呼吸音,心音低钝,心率120次/分。腹软,无压痛,双下肢无水肿,四肢指端发绀。x射线胸片提示右肺下野可见大片状致密阴影。血常规示WBC 17.0x10^9/L,N0.92,L 0.08。 问题: (1)该患者最可能的临床诊断是什么? (2)写出诊断依据与药物治疗方案。
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