CASE PRESENTATION: A 46 year old Hispanic female, who immigrated from Guatemala in 1998, was referred to our clinic for wheezing and suspicion of asthma. She had progressive difficulty breathing which was associated with orthopnea, sinus tenderness, headaches, and fullness in her nares. Patient had no family history of asthma. Denied smoking, seasonal allergies, hospitalizations, or endotracheal intubations. Her pulmonary function tests showed flat inspiratory and expiratory loops and her FEV-1 and FVC values were within the normal range, supporting evidence of fixed extrathoracic airflow obstruction with normal diffusing capacity. CT neck showed an irregular rind of nodular soft tissue lining the walls of the subglottis and the first tracheal ring without erosion of the cricoid cartilage. There was a uniform increased soft tissue density at the level of the posterior and anterior commissure. Bronchoscopy showed mild-moderate narrowing of the subglottic space; dynamic compression of the tracheal walls. The scope was easily transversed past the narrowed part of trachea. Biopsy results revealed Mukulicz cells. Hence, she had evidence of Klebsiella Rhinoscleromatis and was diagnosed with rhinoscleroma. She was initially treated with ciprofloxacin, however, disease progressed necessitating septoplasty and lysis of adhesions in her nasopharynx.