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Pediatrics in Review Sep 2020
Topics: Bacterial Infections; Humans; Tracheitis
PubMed: 32873566
DOI: 10.1542/pir.2019-0181 -
Otolaryngology--head and Neck Surgery :... Mar 2019To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key... (Review)
Review
OBJECTIVE
To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis.
STUDY DESIGN
Case series with literature review.
SETTING
Tertiary children's hospital and available literature.
SUBJECTS AND METHODS
Case series of children with bacterial tracheitis retrospectively reviewed at a tertiary children's hospital. Those with a tracheostomy or those who developed bacterial tracheitis as a complication of prolonged intubation were excluded.
RESULTS
Thirty-six children were identified (mean ± SD age, 6.7 ± 4.5 years). The most common presenting symptom was cough (85%), followed by stridor (77%) and voice changes/hoarseness (67%). A concurrent viral illness was found for 55%, and the most common bacteria cultured was methicillin-sensitive Staphylococcus aureus. Pediatric intensive care admission occurred for 69%, and 43% required intubation. No patient required tracheostomy. One patient (2.7%) died secondary to airway obstruction and subsequent respiratory arrest. Four patients had recurrence of bacterial tracheitis 4 to 12 months following their initial presentation.
CONCLUSION
Bacterial tracheitis is an uncommon condition with an atypical presentation and variable clinical course but serious consequences if left unrecognized. Staphylococcus is the most common bacteria identified, and many patients will have a prodromal viral illness. Changes in patient epidemiology and presentation may have occurred over time.
Topics: Airway Obstruction; Child; Child, Preschool; Cohort Studies; Female; Hospitalization; Humans; Male; Pneumococcal Infections; Staphylococcal Infections; Tracheitis
PubMed: 30348058
DOI: 10.1177/0194599818808774 -
The Journal of Laryngology and Otology Nov 1989Bacterial tracheitis is the term used to describe a severe infraglottic infection characterized by toxicity, brassy cough, inspiratory stridor, subglottic oedema and the... (Review)
Review
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.
Topics: Bacterial Infections; Child; Child, Preschool; Female; Humans; Length of Stay; Male; Recurrence; Tracheitis
PubMed: 2691598
DOI: 10.1017/s0022215100110989 -
Medecine Et Maladies Infectieuses Nov 2017The trachea is a pivotal organ of the respiratory tract. Rather than a genuine anatomic border, it acts as a crossroad in all respiratory infectious processes. Even... (Review)
Review
The trachea is a pivotal organ of the respiratory tract. Rather than a genuine anatomic border, it acts as a crossroad in all respiratory infectious processes. Even though not strictly limited to the trachea, infections such as laryngotracheitis and tracheobronchitis are frequently diagnosed in children, in particular during the winter season. Infectious tracheitis etiologies are diverse and the distinction between viral and bacterial origins, albeit difficult, remains relevant considering the substantial differences in terms of gravity and therapeutic management. This literature review summarizes the microbiological and clinical aspects of community-acquired and nosocomial tracheitis in adults and children, as well as the adequate diagnostic and therapeutic approaches. It also highlights the emergence of fungal tracheitis in immunocompromised patients, of ventilator-associated tracheitis in intensive care medicine, and beyond all that the potential short and long-term consequences of tracheitis.
Topics: Adult; Age of Onset; Bacterial Infections; Child; Community-Acquired Infections; Cross Infection; Diagnosis, Differential; Humans; Immunocompromised Host; Mycoses; Respiration, Artificial; Tracheitis; Virus Diseases
PubMed: 28757125
DOI: 10.1016/j.medmal.2017.06.006 -
Seminars in Pediatric Infectious... Jan 2006Despite the advances that have been achieved in supportive pediatric intensive care, tracheitis remains a significant cause of reversible upper-airway obstruction in... (Review)
Review
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.
Topics: Airway Obstruction; Anti-Bacterial Agents; Child; Humans; Intensive Care Units, Pediatric; Intubation, Intratracheal; Tracheitis; Tracheostomy
PubMed: 16522500
DOI: 10.1053/j.spid.2005.11.004 -
Pediatrics in Review Nov 2014
Topics: Anti-Bacterial Agents; Child; Cold Temperature; Cough; Diagnosis, Differential; Fever; Humans; Laryngoscopy; Pharyngitis; Radiography; Seasons; Trachea; Tracheitis
PubMed: 25361911
DOI: 10.1542/pir.35-11-497 -
European Annals of Otorhinolaryngology,... Oct 2022
Topics: Anti-Bacterial Agents; Gram-Negative Bacteria; Humans; Tracheitis
PubMed: 35078731
DOI: 10.1016/j.anorl.2021.11.010 -
The American Journal of Emergency... May 1991Bacterial 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... (Review)
Review
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.
Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Pneumococcal Infections; Radiography; Respiratory Insufficiency; Tracheitis
PubMed: 2018595
DOI: 10.1016/0735-6757(91)90087-z -
CMAJ : Canadian Medical Association... Jan 1989We examined the records of 14 patients aged 7 months to 10 1/4 years who were treated for bacterial tracheitis from May 1982 to December 1987; the management protocol... (Review)
Review
We examined the records of 14 patients aged 7 months to 10 1/4 years who were treated for bacterial tracheitis from May 1982 to December 1987; the management protocol for 13 of the patients included the use of nasotracheal intubation. The infection was caused by Staphylococcus aureus in seven, Haemophilus influenzae in three, Branhamella catarrhalis in one and Streptococcus pneumoniae in one. Both H. influenzae and B. catarrhalis were isolated in another patient, and no organism was found in the remaining patient. In addition to the bacteria, viruses were cultured from the tracheal secretions of two patients. The mean duration of intubation was 7.6 days and of hospital stay 9.2 days. Twelve of the cases occurred during the cold months of the year (October to March). Of the three deaths only one occurred in the pediatric intensive care unit and was due to severe bronchospasm and an air leak that caused bilateral pneumothorax and pneumomediastinum. In one patient subglottic stenosis developed that necessitated tracheostomy. Healing began 5 to 9 days after the onset of symptoms, as demonstrated with the use of repeated fibreoptic bronchoscopy. We found that the airway could be safely managed with the use of a nasotracheal tube. Bronchoscopy helped to confirm the diagnosis, to remove adherent secretions and to monitor the course of the disease. The ventilation tube can be removed after the patient's temperature returns to normal, if there is an air leak around the tube, if the quantity and viscosity of the secretions decrease and if healing is observed at bronchoscopy.
Topics: Airway Obstruction; Bacterial Infections; Bronchoscopy; Child; Child, Preschool; Female; Humans; Infant; Intubation, Intratracheal; Male; Retrospective Studies; Seasons; Tracheitis
PubMed: 2642395
DOI: No ID Found -
Scandinavian Journal of Infectious... 2009The published literature on bacterial tracheitis is limited. We report the first multi-centre study of bacterial tracheitis together with a concise review of the... (Review)
Review
The published literature on bacterial tracheitis is limited. We report the first multi-centre study of bacterial tracheitis together with a concise review of the literature. We conducted a retrospective study of cases admitted during the period 1993-2007 to 3 tertiary paediatric centres in the United Kingdom and 1 in Australia. A total of 34 cases were identified. 31 patients (91%) required intubation. Complications included cardiorespiratory arrest in 1, ARDS in 1, hypotension in 10, toxic shock syndrome in 1 and renal failure in 1 patient(s). Staphylococcus aureus was the most commonly implicated bacterial organism, isolated from the respiratory tract in 55.8% of the cases overall. Other pathogens commonly isolated from the respiratory tract included Streptococcus pyogenes (5.9%), Streptococcus pneumoniae (11.8%) and Haemophilus influenzae (11.8%). Viral coinfection was identified in 9 (31%) of the 29 cases in whom immunofluorescence testing was performed (influenza A in 4 cases; parainfluenza 1 in 2 cases; parainfluenza 3 in 2 cases; adenovirus in 1 case). The combined experience from 4 major paediatric intensive care units suggests that bacterial tracheitis remains a rare condition with an estimated incidence of approximately 0.1/100,000 children per year. Short-term complications were common but long-term sequelae were rare. There were no fatal outcomes, which contrasts with the high historical mortality rates and likely reflects improvements in intensive care management.
Topics: Adolescent; Australia; Bacteria; Bacterial Infections; Child; Child, Preschool; Comorbidity; Female; Humans; Incidence; Infant; Male; Retrospective Studies; Tracheitis; United Kingdom; Virus Diseases; Viruses
PubMed: 19401934
DOI: 10.1080/00365540902913478