A 60-year-old woman presenting with cough and fever for 8 days was referred as an inpatient because a chest radiograph obtained at another hospital revealed consolidation in the right upper lung suggestive of pneumonia. The patient had a medical history of pulmonary tuberculosis and nephritis. At the age of 49 years, a smoldering form of adult T-cell leukemia was diagnosed; and due to an increase in WBC count, she was treated with oral cyclophosphamide for 3 years. Thereafter, she had been in stable condition and followed up by careful observation at a hematology clinic. Four years previously, she had been hospitalized for 2 weeks and treated with aciclovir for herpes zoster.