Bacterial Tracheitis

Aka: Bacterial Tracheitis, Pseudomembranous Croup

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II. Epidemiology

  1. Affects older children than in croup (ages 1-8 years)

III. Pathophysiology

  1. Secondary infection of viral Upper Respiratory Infection (e.g. croup)

IV. Causes

  1. Staphylococcus aureus
  2. Streptococcus species
  3. Moraxella catarrhalis
  4. Haemophilus Influenza
  5. Anaerobic Bacteria

V. Symptoms

  1. Prodrome of upper respiratory symptoms
  2. Anterior Neck Pain
  3. Rapidly progresses to severe life-threatening illness
    1. Fever (abrupt onset)
    2. Stridor
    3. Cough
    4. Toxic, ill appearance

VI. Signs

  1. Toxic appearance
  2. High Fever
  3. Difficulty controlling secretions (Drooling, unable to swallow)
  4. Purulent airway secretions
  5. Respiratory distress
  6. Does not respond to Croup therapies
    1. Unresponsive to Racemic Epinephrine or mist therapy

VII. Differential Diagnosis

  1. See Pediatric Airway Obstruction Causes
  2. See Stridor
  3. Laryngo-tracheo Bronchitis (Croup)
  4. Epiglottitis

VIII. Imaging

  1. Lateral Neck Xray
    1. Tracheal pseudomembrane
    2. Necrotic epithelium subdivides trachea lumen
  2. Bronchoscopy
    1. Tracheal pseudomembranes
    2. Purulent secretions

IX. Management

  1. Keep patient calm (same tenets for croup, Epiglottitis, Foreign Body Aspiration)
  2. Endotracheal Intubation
  3. Emergent management
    1. See Rapid Cardiopulmonary Asessment in Children
    2. See ABC Management
    3. See Respiratory Distress in the Newborn
    4. See Newborn Resuscitation
    5. See Pediatric Sepsis
  4. Broad Spectrum Antibiotics including coverage for MRSA
    1. Antibiotics are similar to those for Epiglottitis
    2. Example: Vancomycin and Ceftriaxone

X. References

  1. Dahan, Campbell and Melville (2020) Crit Dec Emerg Med 34(11): 3-10

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Related Studies

Ontology: Acute membranous laryngitis (C0339874)

Concepts Disease or Syndrome (T047)
SnomedCT 232428009
English Acute membranous laryngitis, Pseudomembranous croup, Acute membranous laryngitis (disorder)
Spanish laringitis membranosa aguda (trastorno), laringitis membranosa aguda
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Bacterial tracheitis (C1868703)

Definition (NCI) Bacterial infectious process with formation of mucopurulent membranes affecting the trachea. Causative agents include Staphylococcus, Streptococcus, Haemophilus influenzae, Pseudomonas, and Klebsiella.
Definition (NCI_CTCAE) A disorder characterized by an infectious process involving the trachea.
Concepts Disease or Syndrome (T047)
Dutch bacteriële tracheïtis
French Trachéite bactérienne
German bakterielle Tracheitis
Italian Tracheite batterica
Portuguese Traqueíte bacteriana
Spanish Traqueítis bacteriana
Japanese ｻｲｷﾝｾｲｷｶﾝｴﾝ, 細菌性気管炎
Czech Bakteriální tracheitida
English Bacterial Tracheitis, Tracheitis, Bacterial tracheitis
Hungarian Bacterialis tracheitis
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Airway Disorders

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