tracheitis

Introduction

Inflammation of the mucous membrane of the trachea.

Etiology

• bacterial infection
  • Staphylococcus aureus
  • Haemophilus influenzae
  • beta-hemolytic Streptococcus
• viral infection
  • influenza
  • respiratory syntytial virus (RSV)
  • parainfluenza
  • many cases follow measles
• relapsing polychondritis
• Down's syndrome may be predisposing factor

Epidemiology

• uncommon
• most < 3 years of age
• 75% of cases in winter

Clinical manifestations

• croupy of brassy cough
• inspiratory stridor
• wheezing is unusual
• fever (often > 102 F)
• thick, purulent secretions
  • poorly mobilized
  • may become inspissated

Laboratory

• complete blood count (CBC) (leukocytosis, left shift)
• gram stain & culture of tracheal secretions
• blood cultures are generally negative

Diagnostic procedures

• laryngoscopy (rule-out epiglottitis)

Radiology

• lateral X-ray of neck (normal epiglottis)

Complications

• outcome may be fatal

Differential diagnosis

• viral croup
• epiglottitis
• diphtheria
• herpes simplex (necrotizing)
• cytomegalovirus (CMV) in immunosuppressed patients
• invasive Aspergillosis in immunosuppressed patients

Management

• airway maintenance
  • suction
  • endotracheal intubation as needed
  • humidification of inspired gas
• antibiotic therapy
  • IV administration for 5-6 days
  • oral therapy continued for total duration of 2 weeks
  • levofloxacin or 3rd generation cephalosporin

More general terms

• tracheal disorder
• upper respiratory tract infection (URI, common cold)

More specific terms

• croup (laryngotracheobronchitis)

Additional terms

• bronchitis
• laryngitis