A 9-year-old American Quarter Horse mare was examined for evaluation of harsh respiratory sounds and coughing made during exercise and serosanguinous bilateral nasal discharge that had been present for 3 months. The mare initially was treated with ceftiofur sodium by the referring veterinarian (Naxel, Upjohn; 2.2 mg/kg IM q12h) for five days and then with procaine penicillin G (22.000 IU/kg IM q12h) and gentamicin sulfate (6.6 mg/kg IM q24h) for 7 days. Despite treatment, clinical signs did not change.The mare was in good physical condition and showed good appetite and normal behavior. Rectal temperature was 37.9ЊC; heart rate at rest was 36 beats per minute, and respiratory rate was 20 breaths per minute. The mare had a slight, odorless, bilateral mucohemorrhagic nasal discharge and mild inspiratory and expiratory sounds, but abnormal lung sounds were not heard during auscultation. Mandibular and retropharyngeal lymph nodes were not enlarged or painful on palpation. Tracheal rings felt firm and thickened on palpation. Nasal passages, guttural pouches, and the larynx appeared normal during endoscopic examination. Endoscopy of the trachea, however, revealed numerous granulomatous and partially erosive lesions in the proximal half of the trachea that had narrowed the tracheal lumen (Fig. 1). A cytological smear of the transendoscopical aspirate taken from the areas with granulomatous changes in the mucosa was highly cellular, with no evidence of bacteria, fungi, or neoplastic cells. Sixty percent of the cells were nondegenerate segmented neutrophils, and 40% were eosinophils. Fibrinogen concentration, results of a CBC, and serum biochemistries were within the reference range. Radiography showed an irregular tracheal lining extending the entire length of the tracheal lumen. Radiographic lesions within the lungs were not observed. Alpha-hemolytic Streptococcus spp. and a few colonies of gram-negative rods, most likely Actinobacillus sp., were cultured aerobically from tissue obtained by transendoscopic biopsy of granulomatous tracheal lesions.Intense infiltration of the submucosa with predominantly eosinophils, lesser numbers of neutrophils, and still fewer macrophages was found during histologic examination of the biopsy tissue. Multiple hypereosinophilic, 100-300-m foci with a central clear zone surrounded by degranulated eosinophilic granulocytes and nuclear debris (Splendore-