男孩，1岁半，发热伴咳嗽5天，加重伴呼吸困难1天，曾用青霉素治疗3天。査体：T390C，R55次/分，躯干可见散在红色斑丘疹，呼吸急促，亩闻及中小水泡。血：WBC22X109/L,NO.8,胸部X线片示双肺斑片影，肺大疱。首选考虑的诊断是

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