A bacterial infection of the trachea capable of producing airway obstruction .
Alternative Names
Bacterial tracheitis; Acute bacterial tracheitis
Causes, incidence, and risk factors
Bacterial tracheitis is most often caused by Staphylococcus aureus and frequently follows a recent viral upper respiratory infection . Young children are primarily affected, possibly because of the decreased diameter of the trachea relative to the swelling . Children may still have a cough from their previous infection but this rapidly worsens. The child quickly develops a high pitched, crowing sound with breathing that is called stridor (usually on inhalation, called inspiratory stridor) and increasing breathing difficulty . Fever is generally high and the child looks very ill (toxic). This condition may progress very rapidly. These children may sound as if they have croup , but the usual croup treatments do not improve the breathing difficulty. Tracheitis requires hospitalization and, almost always, a breathing tube (endotracheal tube) in order to maintain an open airway. The infection is treated with an antistaphylococcal medications such as penicillin or a cephalosporin that covers staphylococcus. If a different organism is at fault, the appropriate antibiotic is used.
Signs and tests
culture, nasopharyngeal (shows Staphylococcus aureus or other organisms)
culture, tracheal (shows Staphylococcus aureus or other organisms)
blood gasses (show decreased oxygen saturation, decreased pO2) X-ray of the trachea (shows narrowing of the tracheal airway, but the epiglottis is normal) purulent tracheal secretions may be obtained while placing the breathing tube in the patient
Treatment
The child often needs to have an airway or breathing tube placed (endotracheal tube). Antibiotics are given through a vein, usually a type of penicillin or one of the cephalosporins. Oxygen is usually given, and the blood gases are monitored to be sure that the child is breathing adequately.
Expectations (prognosis)
Full recovery is expected if the patient can be brought to a medical facility in time.
Calling your health care provider
Go to the emergency room if your child has had a recent upper respiratory infection and suddenly develops a high fever , worsening cough , and breathing difficulty . This is a true emergency and requires immediate medical attention.
Prevention
Many cases are not preventable.