Bacterial Tracheitis

Basics

Description

A tracheal infection potentially causing acute airway obstruction. Also known as bacterial croup and laryngotracheobronchitis. Exudative tracheitis can refer to a less severe form of disease
Usually secondary bacterial infection of trachea, complicating antecedent viral infection, or less commonly, instrumentation
Fatal in 0–20%
Tracheal membrane formation, purulent discharge, subglottic edema, erosions, with normal epiglottis
Classically presents with prodrome similar to croup followed by rapid deterioration and loss of airway patency
Mean age 5 yr; rarely occurs in adults
More common in children than epiglottitis, presumably due to success of Haemophilus influenzae immunization
More frequent August–December

ALERT
Patients may present with a fairly benign course, followed by rapid deterioration, with respiratory distress, toxic appearance, and acute airway obstruction

Etiology

Staphylococcus aureus (with occ. methicillin-resistant S. aureus [MRSA])
Moraxella catarrhalis
Streptococcus pneumoniae
Group A streptococcal species
Pseudomonas aeruginosa
H. influenzae type B
Escherichia coli
Anaerobes
Klebsiella pneumoniae
Nocardia
Associated with influenza A (including H1N1) and B, parainfluenza, adenovirus, and RSV viral infections
Aspergillus, HSV in immunocompromised hosts (HIV)

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