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.
Entire Body System
- 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]
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]
[…] tracheitis [ tra″ke-i´tis ] inflammation of the trachea. bacterial tracheitis an acute crouplike bacterial infection of the upper airway in children, with coughing and high fever. [medical-dictionary.thefreedictionary.com]
Hence, the initial symptoms of cough, runny nose, and low-grade fever, may be present. [dovemed.com]
- Recent Upper Respiratory Infection
One of the most common causes is Staphylococcus aureus and often follows a recent viral upper respiratory infection. Bacterial tracheitis is a rare complication of influenza infection. [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 Bower J, McBride JT. [nlm.nih.gov]
- Pathologist
• Laryngitis, hoarseness, or breathiness that lasts for more than two weeks may signal a voice disorder and should be followed up with a voice pathologist. 42. [slideshare.net]
Respiratoric
- Cough
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]
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]
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]
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]
Emergency drug & fluid calculator The signs of partial acute upper airway obstruction are: Stridor. [rch.org.au]
This can make the child worried, and may exaggerate hyperventilation The volume of stridor can also indicate the severity of the respiratory distress. [almostadoctor.co.uk]
- Hoarseness
Drosera rotundifolia Deep, hoarse cough, rather paroxysmal, with muco-purulent expectoration and rough, scraped sensation in the trachea. Hepar sulphur Dry, rough, hoarse cough with audible wheezing. [homeoarticle.blogspot.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]
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]
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]
- Rhinitis
Inflammation of the trachea is often combined with rhinitis, pharyngitis, laryngitis or bronchitis, as well as chronic tonsillitis with the corresponding clinical picture. [acikgunluk.net]
Tracheitis, whose symptoms are similar to laryngitis or rhinitis is an inflammation, progressive in the tracheal mucosa. [noillen.bitballoon.com]
Dutch infecties en parasitaire aandoeningen laryngitis Finnish ortostaattinen hypotensio2, kohonnut verenpaine, ääreisosien kylmyys Last Update: 2012-04-11 Usage Frequency: 2 Quality: Dutch fungale dermatitis laryngitis rhinitis onychomycosis Finnish [mymemory.translated.net]
Acute tracheitis begins with acute rhinitis (see) and Qatar nasopharynx, then the inflammatory process covers the trachea. The main symptom of acute tracheitis is cough, disturbing sick at night and especially in the morning. [medicalency.com]
It occurs with rhinitis, adenoids, sinusitis, various tumors, Joan atresia, septal curvature, anomalies of the structures of the nose. [en.medicine-worlds.com]
- 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]
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]
Symptoms of tracheitis Acute viral tracheitis is characterized by the following symptoms: The main symptom of the disease is cough. Dry cough becomes wet with expectoration of sputum. [euromd.com]
Gastrointestinal
- Dysphagia
Other possible diagnoses Symptoms Possible Diagnosis High Fever Hyperextension of neck Dysphagia, pooling of secretions in throat epiglottitis retropharyngeal / peritonsillar abscess "Toxic" appearing child Markedly tender trachea bacterial tracheitis [rch.org.au]
Presentation Swollen tonsils Membrane over the back of the palate (fauces) Polyneuritis – often involves the cranial nerves Shock Dysphagia Muffled voice Cough Airway obstruction Bronchopneumonia Myocarditis – do regular ECG ’s on all diphtheria patients [almostadoctor.co.uk]
[…] of smell Watchful waiting in mild cases; amoxicillin for severe or complicated bacterial rhinosinusitis 10 Common cold Runny nose, cough, sore throat, sneezing, nasal congestion Symptomatic treatment; antibiotics are not recommended 11 Epiglottitis Dysphagia [aafp.org]
Symptoms • Dysphonia (hoarseness) or aphonia (inability to speak) • Dry, sore, burning throat • Coughing • Dysphagia (difficulty in swallowing) • Cold or flu-like symptoms (which, like a cough, may also be the causal factor for laryngitis) • Lymphadenopathy [slideshare.net]
Cardiovascular
- 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]
pain Respiratory distress in varying degrees such as retraction, dyspnea and nasal flaring Drooling often due to difficulty in breathing Patient may experience lethargy Feeling of discomfort in supine position Pain while breathing Tracheitis Causes Tracheitis [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]
Neurologic
- Lethargy
[…] is difficult Headache Dizziness or feeling of light headedness Cyanosis Sore throat Chest pain Respiratory distress in varying degrees such as retraction, dyspnea and nasal flaring Drooling often due to difficulty in breathing Patient may experience lethargy [symptomscausestreatment.com]
• Gas exchange abnormalities lead to anxiety, lethargy, and obtundation. • The presence of these latter symptoms signals the need for intervention. • This negative pleural pressure alters the balance of hydrostatic and oncotic forces within the pulmonary [slideshare.net]
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.
X-Ray
- Subglottic Narrowing
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]
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]
Radiographs of the neck can show the typical subglottic narrowing, or steeple sign, of croup on the posteroanterior view ( Fig. 377-1 ). [clinicalgate.com]
Microbiology
- Corynebacterium Diphtheriae
Corynebacterium diphtheriae causes laryngeal diphtheria; bacterial tracheitis, laryngotracheobronchitis, and laryngotracheobronchopneumonitis come from a virus infection, followed by a bacteria infection. [diki.pl]
This is caused by the toxin of the bacterium Corynebacterium Diphtheriae. [almostadoctor.co.uk]
- Bordetella Pertussis
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]
Few cases of acute bronchitis are caused by Bordetella pertussis or atypical bacteria, such as Chlamydia pneumoniae and Mycoplasma pneumoniae. [aafp.org]
Treatment
Study objectives: Primary to demonstrate a hoarseness or cough relief within 20 minutes after first administration of treatment with the spray. [clinicaltrials.gov]
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]
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]
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
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]
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]
Prognosis Acute uncomplicated banal tracheitis has a favorable prognosis. In complicated forms and hyperacute hemorrhagic tracheitis is cautious and even serious. [m.iliveok.com]
Tracheitis in children - Treatment and prognosis The disease affects children of all ages, including infants. [noillen.bitballoon.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
[…] inflammation that starts on anterior surface of epiglottis -> supraglottis structures which leads to critical narrowing of the respiratory tract & causes stridor -rapid progression -tripod position (upright, bracing themselves on their hands) List the common etiologic [quizlet.com]
Tracheitis classification Depending on the etiological factor of tracheitis is: Infectious: bacterial; viral; mixed or bacterial viral. Allergic. Infectious-allergic. The course of the disease may be: Sharp Chronic. [en.medicine-worlds.com]
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]
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.com]
Describe the pertinent epidemiologic features of epiglottitis rare, since the introduction of the Hib vaccine ( most often affects children age 2-7 life threatening due to obstruction of airway Describe the clinical manifestations of epiglottitis -difficulty [quizlet.com]
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]
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 can be fatal [medbullets.com]
References
- Al-Mutairi B, Kirk V. Bacterial tracheitis in children: Approach to diagnosis and treatment. Paediatr Child Health. 2004;9(1):25-30.
- Jones R, Santos JI, Overall JC Jr.Bacterial tracheitis. JAMA. 1979;242(8):721–726.
- Stern RC. Acute laryngotracheobronchitis. 3rd ed. Philadelphia: WB Saunders; 1983.
- Johnson J, Liston S. Bacterial tracheitis in adults. Arch Otolaryngol Head Neck Surg. 1987;113(2):204–205.
- Hopkins BS, Johnson KE, Ksiazek JM, et al. H1N1 influenza A presenting as bacterial tracheitis. Otolaryngol Head Neck Surg. 2010;142(4):612-614.
- 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.
- Gallagher P. An approach to the diagnosis and treatment of membranous laryngotracheobronchitis in infants and children. Pediatr Emerg Care. 1991;7(6):337–342.
- Nelson W. Bacterial croup: A historical perspective. J Pediatr. 1984;105(1):52–55.
- Britto J, Habibi P, Walters S, Levin M, Nadel S. Systemic complications associated with bacterial tracheitis. Arch Dis Child. 1996;74(3):249–250.
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Han BK, D J, Striker TW. Membranous laryngotracheobronchitis (membranous croup). AJR Am J Roentgenol. 1979;133(1):53–58.