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At least 19 recordsLinked to original sources
PubMed1993

Airway endoscopy in the diagnosis and treatment of bacterial tracheitis in children.

Children with bacterial tracheitis present with the symptoms of viral laryngotracheobronchitis or epiglottitis, but do not respond to appropriate therapy for these diseases and frequently develop acute respiratory decompensation. Since the treatment and outcome of bacterial tracheitis differ so much from those of viral laryngotracheobronchitis and epiglottitis, prompt and accurate diagnosis is essential. The aim of this study was to evaluate the significance of different diagnostic characteristics in a group of eleven patients and to compare the results to those recently reported in the pediatric and otorhinolaryngologic literature. The present study suggests that reliable predictive factors do not exist for bacterial tracheitis. No single clinical, radiological or laboratory feature was a reliable diagnostic predictor for bacterial tracheitis, nor was it any combination of these features. The only diagnostic procedure to distinguish bacterial tracheitis accurately and promptly from other forms of acute obstructive upper airway diseases was direct laryngo-tracheo-bronchoscopy. Following endoscopic removal of all tracheal secretions and pulmonary toilet, nasotracheal intubation provides sufficient airway maintenance and obviates the need for tracheostomy. Endoscopy is thus diagnostic and therapeutic at the same time. If bacterial tracheitis is suspected a direct laryngoscopy and rigid tracheobronchoscopy should be performed under general anesthesia, as prompt diagnosis and adequate treatment are essential to survival. The cultures of the purulent tracheal secretions frequently revealed Staphylococcus aureus in combination with various pathogens, particularly the involvement of Pseudomonas aeruginosa was noted in two patients. Our data imply a susceptibility of children with Down's syndrome or immunodeficiency to bacterial tracheitis.

Acute Disease↗
PubMed2006

Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis.

OBJECTIVE: As a consequence of evolving medical practice, the epidemiology of potentially life-threatening upper airway infections is changing. We report our experience over 9 years with viral croup, epiglottitis, and bacterial tracheitis. PATIENTS AND METHODS: We studied a retrospective case series of patients admitted to Vermont Children's Hospital with potentially life-threatening upper airway infections viral croup, epiglottitis, or bacterial tracheitis between 1997 and 2006. MEASUREMENT AND MAIN RESULTS: There were 107 patients with viral croup admitted to Vermont Children's Hospital, with 16 (15%) admitted to the pediatric intensive care unit. Three patients with croup (17% of pediatric intensive care unit admissions, 3% of total admissions) required intubation. There were no serious complications. Eighteen patients were admitted with bacterial tracheitis. Ninety-four percent (n = 17) were admitted to the pediatric intensive care unit. Eighty-three percent (n = 15) were intubated. Twenty-eight percent of patients (n = 5) developed serious complications. Two adolescent patients were admitted with epiglottitis. Both were intubated and recovered without complications. Of 35 patients admitted to the pediatric intensive care unit with these potentially life-threatening upper airway infections, 20 patients (57%) developed respiratory failure. Fifteen patients (75%) had bacterial tracheitis, 3 patients (15%) had viral croup, and 2 patients (10%) had nonclassic epiglottitis. CONCLUSIONS: Immunization against Haemophilus influenza type b and widespread use of corticosteroids for the treatment of viral croup have changed the epidemiology of acute infectious upper airway disease. As potentially life-threatening infections, viral croup and epiglottitis have been eclipsed by bacterial tracheitis. In this series, bacterial tracheitis was 3 times more likely to have caused respiratory failure than viral croup and epiglottitis combined. Bacterial tracheitis should be considered in children who present with acute life-threatening upper airway infection.

Acute Disease↗
PubMed2000

[Bacterial tracheitis in children].

BACKGROUND: Bacterial tracheitis is an uncommon, but serious cause of acute respiratory distress in children. The incidence is not known. MATERIAL AND METHODS: The medical records of four children with bacterial tracheitis treated in our hospital are presented, and the literature reviewed to describe symptoms, diagnosis and treatment. A questionnaire was sent to all pediatric departments in Norway to assess the incidence of bacterial tracheitis and epiglotitis during the 1994-98 period. RESULTS: The yearly incidence of bacterial tracheitis was estimated to 4 per 1,000,000 for children aged 0-15, and 8 per 1,000,000 for children aged 0-5. The incidence of epiglotitis was 1.0 per 1,000,000 for children 0-15 years. INTERPRETATION: Bacterial tracheitis is now more common than epiglotitis, and the diagnosis has to be considered in children presenting with acute illness and upper airway respiratory distress. The disease is characterised by marked purulent exudate and formation of pseudomembranes in the trachea. Staphylococcus aureus and Haemophilus influenzae type b are the predominant causes of bacterial tracheitis. Most patients require endotracheal intubation, with the highest frequency in the youngest children. Reported complications include cardiopulmonary arrest, toxic shock syndrome and pulmonary oedema. Appropriate treatment with antibiotics is essential.

Bacterial Infections↗
PubMedDate not supplied

Bacterial tracheitis: report of eight new cases and review.

Bacterial tracheitis, previously referred to as nondiphtheritic laryngitis with marked exudate, was commonly discussed in pediatric textbooks before 1940. It seemed to disappear as a clinical entity after that time, but it has been recorded with increasing frequency in the pediatric literature since 1979. We describe eight new cases and review 110 previously described cases. The clinical course consists of a prodromal upper respiratory illness with stridor, fever, and a variable degree of respiratory distress. Unlike patients with croup, patients with bacterial tracheitis do not respond to aerosolized racemic epinephrine. Most patients require endotracheal intubation; some require tracheostomy. Reported complications include pneumonia, pneumothorax, formation of pseudomembranes, toxic shock syndrome, and cardiopulmonary arrest. Bacterial tracheitis is a secondary bacterial infection following a primary viral respiratory infection. The most common preceding viral infection is parainfluenza. Staphylococcus aureus and Haemophilus influenzae are the predominant causes of bacterial tracheitis. Secondary bacterial infection may occur as a result of tracheal mucosal injury or impairment of normal phagocytic function due to viral infection.

Bacterial Infections↗
PubMed2005

[Bacterial tracheitis: an infectious cause of upper airway obstruction to be considered in children].

INTRODUCTION: Bacterial tracheitis is a cause of severe upper respiratory airway obstruction. It has been considered a rare entity whose clinical and epidemiological features are not well known. PATIENTS AND METHODS: The medical records of children diagnosed with bacterial tracheitis and admitted to our pediatric intensive care unit (PICU) from June 1992 to May 2004 (12 years) were analyzed. The following variables were recorded: age, sex, personal history, need for endotracheal intubation, duration of intubation, isolated bacteria, antibiotic treatment, steroid administration, and length of stay in the PICU. RESULTS: Twelve patients (six girls and six boys) were included in this study. Age ranged from 1 month to 13 years (median 24 months). Four children had a history of acute laryngotracheitis, one had Down syndrome and another had interauricular communication. All patients needed orotracheal intubation for 2 to 72 hours (median 48 hours). All patients received empirical antibiotic therapy: cephalosporins in 11 children (91 %) (in association with vancomycin or teicoplanin in four of them) and erythromycin in one (9 %). Corticosteroids were administered in nine patients (75 %). Bacterial pathogens were isolated from tracheal secretion culture in seven children (58 %) and the most common was Staphylococcus aureus (42 %). Three children (25 %) developed lobar pneumonia and one developed congestive cardiac insufficiency as a complication of bacterial tracheitis. In all patients, clinical outcome was satisfactory. CONCLUSIONS: Although the absolute frequency of bacterial tracheitis is low, in our environment this entity represents a considerable cause of severe upper respiratory airway obstruction secondary to an infectious process. Therefore, it should be considered in patients who present with stridor and fever. If the correct treatment is provided, the prognosis is generally good.

Adolescent↗
PubMed1981

Bacterial tracheitis.

Bacterial tracheitis is a recently described clinical entity characterized by high fever, stridor, and airway obstruction. Laryngoscopy shows membraneous inflammation with notable subglottic edema and copious mucopus in the trachea. Staphylococcus aureus is the most common bacterium to be cultured. Subglottic narrowing can be seen on lateral soft-tissue roentgenograms of the neck. Bacterial tracheitis should be treated by establishing a controlled airway by endotracheal intubation or tracheotomy, rather than by usual modalities used for the treatment of croup. Bacterial tracheitis seems to be similar to croup but is more likely to be fatal. Two of the five patients described herein died.

Child↗
PubMed1997

Bacterial tracheitis caused by Corynebacterium diphtheriae.

UNLABELLED: Diphtheria has become a rare disease in Germany. We report on an unimmunized 3.5-year-old German girl with a 7-day history of respiratory distress and fever, presenting a clinical picture mimicking typical bacterial tracheitis without pharyngeal and laryngeal manifestation. Diagnosis of diphtheria was not made until culture of tracheal secretions yielded growth of a toxigenic strain of Corynebacterium diphtheriae. The patient died from toxic cardiac failure despite treatment with diphtheria antitoxin. This is the second reported case of isolated bacterial tracheitis caused by Corynebacterium diphtheriae. CONCLUSION: The observation of a lethal course of diphtheric tracheitis emphasizes the paramount importance of immunization against diseases like diphtheria.

Bacteriological Techniques↗
PubMed1991

Pneumococcal bacterial tracheitis.

Bacterial tracheitis is an uncommon cause of acute respiratory distress in children. The authors present a case of bacterial tracheitis in a 6-year-old girl caused by an unusual pathogen, Streptococcus pneumoniae. Her clinical presentation and radiographic findings are typical for an older child. Management of this case involved endotracheal intubation, although a review of the literature suggests that airway management can vary with age and size of the tracheal lumen. The microbiology of bacterial tracheitis shows a predominance of Staphylococcus and Streptococcus reported previously, with only three prior reported cases of Pneumococcus.

Adolescent↗
PubMed1989

Bacterial tracheitis.

Bacterial tracheitis is the term used to describe a severe infraglottic infection characterized by toxicity, brassy cough, inspiratory stridor, subglottic oedema and the presence of copious mucopurulent secretions in the trachea. It is an uncommon condition that requires prompt diagnosis and intensive medical therapy if significant morbidity and mortality are to be avoided. Since the condition was first described in 1979 approximately one hundred cases have been reported. In this paper we present four children with bacterial tracheitis to add to the current literature. Interestingly, one child was admitted on two separate occasions with the disease, an event not previously recorded. All patients underwent endoscopy which revealed findings typical of bacterial tracheitis in each case. None required tracheostomy though three required nasotracheal intubation. Post-endoscopy all were managed in the Intensive Care Unit. There were no fatalities or significant morbidity. The average duration of hospitalization was seven days.

Bacterial Infections↗
PubMed2006

Tracheitis in pediatric patients.

Despite the advances that have been achieved in supportive pediatric intensive care, tracheitis remains a significant cause of reversible upper-airway obstruction in pediatric patients. This discussion highlights the epidemiology and clinical presentation of tracheitis in the twenty-first century and reviews diagnostic and therapeutic modalities. The gold standard for therapy remains supportive airway management in conjunction with appropriate antibiotic therapy. Finally, the unique challenges of diagnosis and treatment of tracheitis in the technology dependent child with an existing artificial airway (endotracheal tube or tracheostomy) are addressed.

Airway Obstruction↗
PubMed1997

Aerobic and anaerobic microbiology of bacterial tracheitis in children.

STUDY OBJECTIVES: Establish the aerobic and anaerobic microbiology of bacterial tracheitis in children. METHOD: Retrospective review of specimens obtained from 14 children with bacterial tracheitis that were cultured for aerobic and anaerobic bacteria. RESULTS: A total 30 bacterial isolates were recovered, 17 aerobic and facultative anaerobic and 13 anaerobic. Aerobic bacteria only were present in six (43%) specimens, anaerobes only in three (21%), and mixed aerobic and anaerobic flora in five (36%). Polymicrobial flora was recovered in 10 of the 14 specimens. The predominant organisms were Staphylococcus aureus (5 isolates), Haemophilus influenzae type b (4), Peptostreptococcus sp. (4), pigmented Prevotella and Porphyromonas (4), Fusobacterium sp. (2), and Moraxella catarrhalis (2). Two organisms that were also isolated from the tracheal aspirates were recovered from the blood of two patients (one each of H. influenzae and Prevotella intermedia). Eleven beta-lactamase-producing organisms were isolated from nine patients. These included all isolates of S. aureus and M. catarrhalis, and two each of H. influenzae and Prevotella sp. CONCLUSIONS: These data confirm the predominance of S. aureus and H. influenzae in causing bacterial tracheitis in children and suggest a potential role for anaerobic bacteria.

Anti-Bacterial Agents↗
PubMed1996

Systemic complications associated with bacterial tracheitis.

The toxic shock syndrome, septic shock, pulmonary oedema, and the acute respiratory distress syndrome (ARDS) were recognised in four children with bacterial tracheitis. ARDS has not previously been reported in association with bacterial tracheitis. Prompt recognition of the severe systemic complications of bacterial tracheitis could lead to a decrease in the morbidity and mortality of this condition.

Bacterial Infections↗
PubMed1983

Bacterial tracheitis--an old disease rediscovered.

During a 3-year period, seven children with bacterial tracheitis were admitted to the intensive care unit of the Winnipeg Children's Hospital. The illness was characterized by fever, toxicity, and stridor. Respiratory difficulty was secondary to copious thick purulent tracheal secretions. In the majority of patients the illness was caused by Staphylococcus aureus, and the rest had Hemophilus influenzae infection. Viral studies in five patients were negative. Most patients required endotracheal intubation and frequent tracheal toilet to prevent serious airway obstruction. In our ICU, bacterial tracheitis accounted for about 14 per cent of admissions with infectious upper airway obstructive illness, while epiglottis and croup accounted for 55 per cent and 31 per cent, respectively. Only 5 per cent of children with croup admitted to the hospital were admitted to the ICU. Bacterial tracheitis has reappeared, at least in North America, as an important and serious cause of obstructive upper airway disease in children and must be recognized early in order to prevent catastrophic airway obstruction.

Airway Obstruction↗
PubMedDate not supplied

Case report: bacterial tracheitis in an adult female.

Bacterial tracheitis is an extremely rare entity, long considered to be a disease of pediatrics. However, cases continue to be reported among adult patients. We present the case of a 19-year-old female patient who presented to our Emergency Department (ED) with bacterial tracheitis. Other adult cases of bacterial tracheitis as reported in the literature from 1981 to the present are discussed.

Adult↗
PubMed1987

Bacterial tracheitis in adults.

Bacterial tracheitis is characterized by acute upper airway obstruction in which indirect laryngoscopy is normal. Roentgenograms reveal an irregular tracheal air column. Endoscopic evaluation demonstrates a normal supraglottic and glottic larynx with purulent debris, mucosal ulcerations, and edema of the subglottic larynx and trachea. To our knowledge, this entity has not been previously described in an adult. We report herein three cases of bacterial tracheitis in adults.

Adolescent↗
PubMed2003

Life-threatening stridor due to membranous tracheitis as a rare complication of endotracheal intubation: report of a case.

This report describes a rare case of acute life-threatening stridor due to membranous tracheitis that occurred as a complication of endotracheal intubation, performed for video-assisted thoracotomy. An obstructive fibrin clot was found in the subglottic region by bronchofiberscopy, and removal provided complete relief of the airway obstruction. The mechanism of the development of this fibrin membrane may have interacted with local tracheal trauma from the endotracheal tube. Membranous tracheitis should be considered in the differential diagnosis of stridor and airway obstruction after endotracheal intubation because it is a life-threatening complication of this procedure.

Female↗
PubMed2004

Bacterial tracheitis reexamined: is there a less severe manifestation?

OBJECTIVE: Bacterial tracheitis (BT) is a condition that can cause fatal airway obstruction. We evaluated our experience with BT over a 10-year period. STUDY DESIGN: Retrospective review of patients treated for BT between 1991 and 2001. RESULTS: Ninety-four cases were evaluated. The mean patient age was 7.9 years. At presentation, 60% were afebrile, and the mean WBC count was 10.8 x 10(3)/mm3 . Only 53% of patients required intubation. Younger children were more likely to require this intervention. S. aureus was the most commonly cultured bacteria, while isolation of M. catarrhalis was associated with a higher intubation rate. A pathologic virus was isolated in 64% of the 34 cultures performed. Only 9 patients were described as "toxic," and 6 presented in respiratory extremis. There were no deaths. CONCLUSION AND SIGNIFICANCE: A subset of patients with tracheal membranes has a less severe clinical appearance. Nonetheless, these patients require debridement and aggressive medical treatment. We propose that the term "exudative tracheitis" (ET) better describes this entity. Older patients who are less systemically ill and rapidly respond to local and systemic therapy are characteristic of ET. EBM RATING: C.

Adolescent↗