A 49 year old man was referred to our hospital in 1994, because of intermittent fever and production of mucopurulent sputum. His complaints started at 43 yrs of age. The symptoms were mostly self-limiting, and occurred five times a year. Over the years, periods of bronchitis had increased to 12 times a year. In addition, a sinusitis with Klebsiella ozaenae became apparent, which was treated with antibiotics and intranasal beclomethasone dipropionate. Coughing was most severe during the night, with production of mucopurulent sputum. The patient's exercise tolerance was normal; he had worked for more than 10 years as a shoemaker. He has no smoking history.Physical examination and routine laboratory investigations were normal. Posteroanterior and lateral chest radiography and lung function tests were normal. A fibreoptic bronchoscopy was performed and showed many abnormalities of the trachea and bronchi (figs. 1 and 2). Specimens were taken for microbiological analysis, and biopsies were sampled for histological examination ( fig. 3). Because of the extent of the abnormalities seen during bronchoscopy, computed tomography (CT) of the chest was performed (figs. 4 and 5).