A 71-year old man was admitted because of increasing dyspnea and fever. Myelomonocytic leukemia was diagnosed on blood films. Diffuse bilateral pulmonary infiltrates detected on chest radiographs were related to the febrile state. Because leukemic infiltrates as well as pneumonia were possible causes for the pulmonary lesions antibiotic therapy followed by prednisone on the same day was initiated. An unusually rapid improvement of the pulmonary infiltrates within 4 days was indicative of a leukemic infiltrate. The patient died a few days later and the diagnosis of diffuse leukemic pulmonary infiltrates was confirmed at autopsy.
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