Bacterial Tracheitis

Basics

Description

  • A tracheal infection potentially causing acute airway obstruction and respiratory failure. Also known as bacterial croup and laryngotracheobronchitis
  • Usually secondary bacterial infection of trachea, complicating antecedent viral infection, or less commonly, instrumentation
  • Annual incidence 0.1 per 100,000 children
  • Fatal in 2–3%
  • 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 of 5 yr; rarely occurs in adults
  • More common in children than epiglottitis, presumably due to success of Haemophilus influenzae immunization
  • More frequent August–December
  • Can be the involvement of subglottic laryngeal structure or associated pneumonia
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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