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We present a case of a 17-year-old female with primary ciliary dyskinesia (PCD) who was treated for asthma. She was born at 40 weeks’ gestation with a history of respiratory distress since birth, intermittent lobar collapse and recurrent wheezing episodes. Ciliary studies performed in infancy were inconclusive, due to nasal inflammation. She had been under the care of tertiary paediatric respiratory services, but later her healthcare became fragmented. She presented with an acute life-threatening exacerbation of asthma at 16 years of age. An X-ray of the chest demonstrated hyperinflation and situs solitus (figure 1). CT scan of the chest showed bilateral bronchial wall thickening with widespread centrilobular ground glass opacities and focal areas of segmental and subsegmental bronchial dilatation (figure 2). Lung function testing showed severe reversible obstruction: forced expiratory volume in one second (FEV1) 1.22 L (41%), forced vital capacity 3.90 L (117%), with post-bronchodilator FEV1 of 1.43 L (17% change).