Search
tracheitis
Inflammation of the mucous membrane of the trachea.
Etiology:
1) bacterial infection
a) Staphylococcus aureus
b) Haemophilus influenzae
c) beta-hemolytic Streptococcus
2) viral infection
a) influenza
b) respiratory syntytial virus (RSV)
c) parainfluenza
d) many cases follow measles
3) relapsing polychondritis
4) Down's syndrome may be predisposing factor
Epidemiology:
1) uncommon
2) most < 3 years of age
3) 75% of cases in winter
Clinical manifestations:
1) croupy of brassy cough
2) inspiratory stridor
3) wheezing is unusual
4) fever (often > 102 F)
5) thick, purulent secretions
a) poorly mobilized
b) may become inspissated
Laboratory:
1) complete blood count (CBC) (leukocytosis, left shift)
2) gram stain & culture of tracheal secretions
3) blood cultures are generally negative
Special laboratory:
- laryngoscopy (rule-out epiglottitis)
Radiology:
- lateral X-ray of neck (normal epiglottis)
Complications:
- outcome may be fatal
Differential diagnosis:
1) viral croup
2) epiglottitis
3) diphtheria
4) herpes simplex (necrotizing)
5) cytomegalovirus (CMV) in immunosuppressed patients
6) invasive Aspergillosis in immunosuppressed patients
Management:
1) airway maintenance
a) suction
b) endotracheal intubation as needed
c) humidification of inspired gas
2) antibiotic therapy
a) IV administration for 5-6 days
b) oral therapy continued for total duration of 2 weeks
c) levofloxacin or 3rd generation cephalosporin
Related
bronchitis
laryngitis
Specific
croup (laryngotracheobronchitis)
General
tracheal disorder
upper respiratory tract infection (URI, common cold)
References
- Stedman's Medical Dictionary 27th ed, Williams &
Wilkins, Baltimore, 1999
- Ferri's Clinical Advisor, Instant Diagnosis and Treatment,
Ferri FF (ed), Mosby, Philadelphia, 2003