A 63-year-old Italian woman was referred to our outpatient pulmonology clinic with a three-month history of productive cough associated with yellowish, flake-like sputum and profound asthenia. She denied fever throughout the course of her illness. Previous courses of oral antibiotics were ineffective. Her past medical history was remarkable only for known bronchiectasis. Physical examination was otherwise unremarkable. Chest computed tomography demonstrated extensive mucoid impaction within dilated bronchi with a characteristic flower-shaped finger-in-glove appearance, obliteration of the distal B6 segmental bronchi, bronchiectasis, and bronchiolectasis (Fig.
