Diffuse panbronchiolitis (DPB) is a chronic, idiopathic, rare but lethal inflammatory airway disease resulting in distal airway dilation, obstructive lung disease, hypoxemia, and increased in the susceptibility of bacteria colonization. The case reports that a patient with destructive lung gets pneumonia by Klebsiella pneumoniae cured by bactericidal antibiotics, but K. pneumoniae in the airway is eradicated with erythromycin, which therefore highlights not only the importance to the testing for DPB in suspicious patients, but also the therapeutic strategies in managing DPB with K. pneumoniae in the airways. (J Intern Med Taiwan 2020; 31: 432-436)