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Acute Tracheitis

Acute tracheitis is a possible cause of an acute airway obstruction caused mainly by a secondary bacterial infection. This potentially life-threatening condition is preceded by an upper respiratory tract viral illness and features symptoms of both epiglottitis and croup. The diagnosis is achieved by the patient's history, physical exam, and the relevant studies.


Presentation

Acute tracheitis, the possible cause of an acute airway obstruction, is caused by a bacterial infection and the subsequent production of mucopurulent exudates [1]. This disease affects young children and infants although there have been case reports of adult patients [2] [3] [4]. Acute tracheitis is typically preceded by croup or other upper respiratory tract viral illnesses and hence is the most prevalent in the winter [1]. Possibly, there is a predilection for males but related data are variable in the literature [1]. Some of the main bacterial agents implicated in this disease include Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, H1N1 influenza virus [5], and Haemophilus influenzae type B.

The clinical presentation of acute tracheitis shares manifestations with epiglottitis and croup. The prodromal upper respiratory tract illness consists of fever, cough, rhinorrhea, and sore throat [1]. Notable features of acute tracheitis include high fever, dyspnea, tachypnea, stridor, cough, and a hoarse voice [6] [7] [8]. The condition of a patient with acute tracheitis may deteriorate rapidly secondary to the airway obstruction. In these cases, there is a risk for respiratory distress which will warrant emergency care. With an early recognition of acute tracheitis and adequate medical care, patients are expected to make a full recovery without long-term consequences [1].

While pneumonia is the most common complication of acute tracheitis [1], patients may be at risk for developing less frequent sequelae such as acute respiratory distress syndrome (ARDS), pulmonary edema, and septic shock [9].

Patients with acute tracheitis exhibit a toxic appearance [1]. Additionally, they demonstrate remarkable exam findings such as inspiratory stridor and possibly expiratory stridor, retractions, bark-like cough, and cyanosis. Vital sign changes are indicative of respiratory distress.

Fever
  • The prodromal upper respiratory tract illness consists of fever, cough, rhinorrhea, and sore throat. Notable features of acute tracheitis include high fever, dyspnea, tachypnea, stridor, cough, and a hoarse voice.[symptoma.com]
  • Treatment of tracheitis antibiotics penicillin group is expedient in cases when a person has observed all the signs of acute bacterial infections, namely purulent sputum, fever, severe cough, and fever.[noillen.bitballoon.com]
  • The low-grade fever can persist, although temperatures can reach 39-40 C (102.2-104 F); some children are afebrile.[clinicalgate.com]
  • It is very serious in young children, possibly because of their small trachea that is easily blocked by swelling The classic signs and symptoms of Bacterial Tracheitis include deep cough, high-grade fever, stridor (high-pitched abnormal sound while breathing[dovemed.com]
  • Symptoms include: Deep cough (similar to that caused by croup ) Difficulty breathing High fever High-pitched breathing sound ( stridor ) The health care provider will perform a physical exam and listen to the child's lungs.[nlm.nih.gov]
Recent Upper Respiratory Infection
  • Increasing deep or barking croup cough following a recent upper respiratory infection Crowing sound when inhaling (inspiratory stridor) 'Scratchy' feeling in the throat Chest pain Fever Ear ache Headache Dizziness (light headed) Labored breathing Bacterial[en.wikipedia.org]
  • Go to the emergency room right away if your child has had a recent upper respiratory infection and suddenly has a high fever, a cough that gets worse, or trouble breathing. Bacterial tracheitis; Acute bacterial tracheitis Cukor J, Manno M.[nlm.nih.gov]
Cough
  • The prodromal upper respiratory tract illness consists of fever, cough, rhinorrhea, and sore throat. Notable features of acute tracheitis include high fever, dyspnea, tachypnea, stridor, cough, and a hoarse voice.[symptoma.com]
  • Acute bronchitis; Acute tracheitis; Cough; Red tongue, yellow coating; Slippery-Rapid pulse (Hua Shu). Luo Han Guo Zhi Ke Lu Unknown Calms cough; Transforms Phlegm-Heat; Moistens the Lungs; Stops cough. Severe cough due to Phlegm-Heat.[tcmassistant.com]
  • The main symptom of chronic tracheitis - cough, stronger in the morning and at night. In some cases, with a dry cough number of viscous sputum small, others sputum rich, mucopurulent character.[medicalency.com]
  • Acute tracheitis: symptoms The main manifestation is perspiration in the throat, dry cough and unpleasant sensations behind the sternum. In this case, the cough is fickle, paroxysmal, accompanied by sputum discharge.[acikgunluk.net]
  • Here are the following features: coughing - are unstable and strong only in the morning.[noillen.bitballoon.com]
Stridor
  • Additionally, they demonstrate remarkable exam findings such as inspiratory stridor and possibly expiratory stridor, retractions, bark-like cough, and cyanosis. Vital sign changes are indicative of respiratory distress.[symptoma.com]
  • Rarely, the upper airway obstruction progresses and is accompanied by an increasing respiratory rate; nasal flaring; suprasternal, infrasternal, and intercostal retractions; and continuous stridor.[clinicalgate.com]
  • It is very serious in young children, possibly because of their small trachea that is easily blocked by swelling The classic signs and symptoms of Bacterial Tracheitis include deep cough, high-grade fever, stridor (high-pitched abnormal sound while breathing[dovemed.com]
  • The most frequent sign is the rapid development of stridor. It is occasionally confused with croup. If it is inflamed, a condition known as tracheitis can occur. In this condition there can be inflammation of the linings of the trachea.[en.wikipedia.org]
  • Symptoms include: Deep cough (similar to that caused by croup ) Difficulty breathing High fever High-pitched breathing sound ( stridor ) The health care provider will perform a physical exam and listen to the child's lungs.[nlm.nih.gov]
Hoarseness
  • Notable features of acute tracheitis include high fever, dyspnea, tachypnea, stridor, cough, and a hoarse voice. The condition of a patient with acute tracheitis may deteriorate rapidly secondary to the airway obstruction.[symptoma.com]
  • Study objectives: Primary to demonstrate a hoarseness or cough relief within 20 minutes after first administration of treatment with the spray.[clinicaltrials.gov]
  • Physical examination can reveal a hoarse voice, coryza, normal to moderately inflamed pharynx, and a slightly increased respiratory rate. Patients vary substantially in their degrees of respiratory distress.[clinicalgate.com]
  • The voice from the accompanying laryngitis (see) may be hoarse. The General condition usually suffer slightly, sometimes there are headaches, a feeling of weakness, temperature more low grade, but children have a temperature of 39 degrees.[medicalency.com]
  • First there is rhinitis, which is subsequently replaced by hoarseness and dry cough. It should be noted that when tracheitis develops, the symptoms of such lesions may be similar to those observed in other respiratory diseases.[acikgunluk.net]
Dry Cough
  • Acute tracheitis: symptoms The main manifestation is perspiration in the throat, dry cough and unpleasant sensations behind the sternum. In this case, the cough is fickle, paroxysmal, accompanied by sputum discharge.[acikgunluk.net]
  • To ease dry coughs, the patient may be given mucolytics to thin phlegm and soothing the inflamed mucosa.[respiratory.vsebolezni.com]
  • Suddenly appeared cold, which soon gives way to a dry cough and hoarseness - this is one of the most obvious signs that a person develops acute tracheitis.[noillen.bitballoon.com]
  • In some cases, with a dry cough number of viscous sputum small, others sputum rich, mucopurulent character. If percussion and auscultation of pathological changes are detectable. The disease long, with temporary improvements.[medicalency.com]
  • Dry cough becomes wet with expectoration of sputum. Pain in cheat and in the interscapular area has thrust character and occurs during the fit of coughing . Violation of the general health, well-being. The body temperature rises to 38⁰C.[euromd.com]
Pertussis
  • Children may develop chronic tracheitis measles or pertussis. The main symptom of chronic tracheitis - cough, stronger in the morning and at night.[medicalency.com]
  • MDC 4 Diseases & Disorders of the Respiratory System Bronchitis and Asthma A3700Whooping cough due to Bordetella pertussis without pneumonia A3701Whooping cough due to Bordetella pertussis with pneumonia A3710Whooping cough due to Bordetella parapertussis[cms.gov]
  • Laryngitis can be infectious or non- infectious Infectious • Viral rhinovirus, influenza, parainfluenza, adenovirus, coronavirus, RSV • Bacterial group A streptococcus, S. pneumoniae, C. diphtheriae, M. catarrhalis, H. influenzae, B. pertussis, B. anthracis[slideshare.net]
  • Chronic banal tracheitis and chronic bronchitis are primarily diseases of adults, but may occur in children after measles, pertussis and other childhood infections, complicated by acute tracheitis.[m.iliveok.com]
Failure to Thrive
  • Fred Ferri’s popular "5 books in 1" format provides quick guidance on menorrhagia, Failure to Thrive (FTT), Cogan’s syndrome, and much more.[books.google.com]
Chest Pain
  • Increasing deep or barking croup cough following a recent upper respiratory infection Crowing sound when inhaling (inspiratory stridor) 'Scratchy' feeling in the throat Chest pain Fever Ear ache Headache Dizziness (light headed) Labored breathing Bacterial[en.wikipedia.org]
  • The infection mainly affects younger children and is associated with symptoms such as coughing , breathing difficulties , high fever , headache , ear ache , chest pain , and high pitched grinding noise while breathing .[humanitas.net]
  • Itchy sensation in the throat is experienced Onset of high fever Stridor or high pitched breathing sound can be heard which can occur abruptly or worsening Breathing is difficult Headache Dizziness or feeling of light headedness Cyanosis Sore throat Chest[symptomscausestreatment.com]
  • If symptoms such as high temperature (fever), chest pains, or headaches become worse or severe. If you develop breathing difficulties such as wheezing or shortness of breath. If you cough up blood.[patient.info]
  • The signs and symptoms of Bacterial Tracheitis may include: Deep or barking cough Inspiratory stridor: A high pitched crowing sound that is heard, while the child breathes in Scratchy feeling in the throat, hoarse voice Fever Chest pain, difficulty breathing[dovemed.com]

Workup

The diagnosis of acute tracheitis is based on the patient's history, physical exam, and the appropriate studies. It's important to note that patients with croup-like manifestations not responding to the standard treatment should be suspected to have acute tracheitis.

A complete blood count (CBC) with differential may reveal leukocytosis in addition to a left shift [1]. Blood cultures should also be obtained although they are mainly negative [6].

Neck radiography (the anteroposterior view) demonstrates subglottic narrowing [2] [10]. Additionally, the lateral view may show the haziness and irregularities of the anterior tracheal wall.

Chest X-ray in at least half of cases will yield findings indicative of pneumonia which complicates the clinical picture [6] [9] [10].

Laryngotracheobronchoscopy is indicated in some patients for direct airway visualization and definitive diagnosis. Confirmatory findings include a narrowed subglottic region, erythematous airway, laryngotracheal inflammation, and exudative tracheal secretions. The epiglottis will usually appear normal or mildly affected [1]. This procedure also enables a therapeutic and diagnostic tracheal toilet in which secretions can be removed and sent for a culture.

Subglottic Narrowing
  • Neck radiography (the anteroposterior view) demonstrates subglottic narrowing. Additionally, the lateral view may show the haziness and irregularities of the anterior tracheal wall.[symptoma.com]
  • An AP film shows subglottic narrowing. The is no improvement with racemic epinephrine. Gross pathology of the disease in a beef heifer is shown. Introduction Bacterial superinfection caused by Staphylococcus aureas or Strep spp.[medbullets.com]
  • Radiographs of the neck can show the typical subglottic narrowing, or steeple sign, of croup on the posteroanterior view ( Fig. 377-1 ).[clinicalgate.com]

Treatment

  • Study objectives: Primary to demonstrate a hoarseness or cough relief within 20 minutes after first administration of treatment with the spray.[clinicaltrials.gov]
  • The treatment should be aimed at eliminating the causes of disease and coincides with the treatment of chronic bronchitis (see). Apply inhalation of antibiotics and oil-alkaline inhalation.[medicalency.com]
  • The most important thing is to believe in the success of the treatment and perfectly fulfill all that says doctor.[respiratory.vsebolezni.com]
  • Tracheitis - treatment in adults Since the disease most often occurs in the body by the action of infection, tracheitis treatment involves the use of various antibiotics.[noillen.bitballoon.com]
  • When signs of tracheitis develop, immediate treatment should be prescribed, which should be comprehensive and include measures aimed at eliminating inflammatory changes and raising local immunity.[acikgunluk.net]

Prognosis

  • Vaccination is the most effective way to prevent Bacterial Tracheitis Please find comprehensive information on Bacterial Tracheitis regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis[dovemed.com]
  • Tracheitis in children - Treatment and prognosis The disease affects children of all ages, including infants.[noillen.bitballoon.com]
  • , Prevention, and Complications Prognosis average to good, depending on timing of diagnosis and aggressiveness of treatment Prevention proactive medical management of croup and other upper respiratory infections Complications respiratory decompensation[medbullets.com]
  • The most effective way to prevent Bacterial Tracheitis is vaccination Vaccination against influenza, measles, and streptococcus pneumoniae, is essential for all children to prevent development of the infection What is the Prognosis of Bacterial Tracheitis[dovemed.com]
  • Prognosis Acute uncomplicated banal tracheitis has a favorable prognosis. In complicated forms and hyperacute hemorrhagic tracheitis is cautious and even serious.[m.iliveok.com]

Etiology

  • In the past, Haemophilus influenzae type b was the most commonly identified etiology of acute epiglottitis.[clinicalgate.com]
  • Etiology It is caused by the same influences – exposure with lack of resistance or the inhalation of irritating matter – that would excite a laryngitis or bronchitis, or may occur secondarily by extension of either of the latter.[homeoarticle.blogspot.com]
  • (Etiology) Bacterial Tracheitis may be caused by a variety of bacteria.[dovemed.com]
  • The chronic form of disease often has a bacterial etiology, thus antibacterial therapy is prescribed.[m.iliveok.com]

Epidemiology

  • Hopkins, A., et al., Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics, 2006. 118(4): p. 1418-21[pedemmorsels.com]
  • Cases usually occur in the fall or winter months, mimicking the epidemiology of viral croup.[emedicine.medscape.com]
  • Caused by long-standing, often untreated, primary viral upper respiratory infection (croup) caused by parainfluenza virus Epidemiology occurs in ages 3 months to 2 years old often a complication of croup Presentation Symptoms prodrome upper respiratory[medbullets.com]
Sex distribution
Age distribution

Pathophysiology

  • […] barking cough, stridor, and fever; however, patients with bacterial tracheitis do not respond to standard croup therapy (racemic epinephrine) and instead require treatment with antibiotics and may experience acute respiratory decompensation. [1, 2, 3, 22] Pathophysiology[emedicine.com]

Prevention

  • […] find comprehensive information on Bacterial Tracheitis regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis, and additional useful information HERE .[dovemed.com]
  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.com]
  • How to keep out disease Bronchitis, like any other disease, it is much easier to prevent than later cure. To treat tracheitis, require a significant amount of time and effort, while prevention does not require any supernatural action.[respiratory.vsebolezni.com]
  • Of course, do not forget about the prevention of disease. Maintain a healthy lifestyle, tempers of their children and then they are not afraid of many viral infections.[noillen.bitballoon.com]

References

Article

  1. Al-Mutairi B, Kirk V. Bacterial tracheitis in children: Approach to diagnosis and treatment. Paediatr Child Health. 2004;9(1):25-30.
  2. Jones R, Santos JI, Overall JC Jr.Bacterial tracheitis. JAMA. 1979;242(8):721–726.
  3. Stern RC. Acute laryngotracheobronchitis. 3rd ed. Philadelphia: WB Saunders; 1983.
  4. Johnson J, Liston S. Bacterial tracheitis in adults. Arch Otolaryngol Head Neck Surg. 1987;113(2):204–205.
  5. Hopkins BS, Johnson KE, Ksiazek JM, et al. H1N1 influenza A presenting as bacterial tracheitis. Otolaryngol Head Neck Surg. 2010;142(4):612-614.
  6. Bernstein T, Brilli R, Jacobs B. Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit. Clin Infect Dis. 1998;27(3):458–462.
  7. Gallagher P. An approach to the diagnosis and treatment of membranous laryngotracheobronchitis in infants and children. Pediatr Emerg Care. 1991;7(6):337–342.
  8. Nelson W. Bacterial croup: A historical perspective. J Pediatr. 1984;105(1):52–55.
  9. Britto J, Habibi P, Walters S, Levin M, Nadel S. Systemic complications associated with bacterial tracheitis. Arch Dis Child. 1996;74(3):249–250.
  10. Han BK, D J, Striker TW. Membranous laryngotracheobronchitis (membranous croup). AJR Am J Roentgenol. 1979;133(1):53–58.

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Last updated: 2018-06-22 08:14