HWN Suggests

Tracheitis in Children: a 2018 Update

Croup can be “fun” to manage – it is a clinical diagnosis that you can treat and you can make the kid feel better – but, what do you do when the “croup” doesn’t respond like you’d expect? Recurrent Croup and “Croup” that fails therapy desires specific attention. You may be dealing with Tracheitis... It’s Challenging to Diagnosis! With the overlapping conditions and the more common entities presenting similarly, it can be difficult to pick up on. Standard imaging does not reliably diagnosis it. It can present dramatically or subtly. Requires high index of suspicion for subtle cases.

read full article

Featured

 EM@3AM: Bacterial Tracheitis

Empiric treatment includes vancomycin or clindamycin in addition to a third-generation cephalosporin (e.g., ceftriaxone, cefotaxime) or a penicillin beta-lactamase inhibitor (e.g., ampicillin-sulbactam). Definitive airway management should be pursued early.

Articles of Interest

Bacterial Tracheitis

Epiglottitis? Think Tracheitis too! Bacterial tracheitis has replaced epiglottitis and croup as the most common cause of acute respiratory failure. One study found it to be 3 times more likely to cause respiratory failure than croup and epiglotittis combined. The mortality rates had been reported as high as 18% to 40%.

Bacterial tracheitis in children: Approach to diagnosis and treatment

Bacterial tracheitis is due to a secondary bacterial infection of the trachea, resulting in the formation of mucopurulent exudates that may acutely obstruct the upper airway, resulting in a life-threatening condition. Bacterial tracheitis should be considered in the differential diagnosis of any child with acute upper airway obstruction. This diagnosis should also be considered in any child with viral croup that is nonresponsive to conventional therapy.

Bacterial tracheitis in children: Approach to diagnosis and treatment

In bacterial tracheitis, pathogenic bacteria invade the trachea and stimulate both local and systemic inflammatory responses. Locally, this results in production of thick, mucopurulent exudates, ulceration and sloughing of the tracheal mucosa . This can result in a variable degree of upper airway obstruction.

Bacterial tracheitis – A life threatening cause of stridor A case report

Bacterial tracheitis is an invasive exudative infection of soft tissues of the trachea. It is an uncommon cause of upper airway obstruction in children and requires a high degree of clinical suspicion for the diagnosis] It commonly affects preschool, early preschool aged children and is less common in infants. Clinical features may be similar to viral croup but these children appear more toxic and clinical response to inhaled epinephrine or systemic corticosteroids is absent or inadequate

Pediatric Bacterial Tracheitis—A Variable Entity: Case Series with Literature Review

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.

Rapid Review: Bacterial Tracheitis

Patient will look like croup but toxic appearing...

Recognizing and Managing Bacterial Tracheitis

Bacterial tracheitis typically occurs during the fall and winter months and presents with signs and symptoms very similar to viral croup, including inspiratory stridor and a cough often described as “barking,” “brassy,” or “seal-like.” This presentation often leads to an initial misdiagnosis of croup. In addition to stridor and the classic cough, there’s typically a history of prolonged upper respiratory infection symptoms, to include runny nose, productive cough, and fever. Marked drooling and dysphagia, commonly seen with epiglottitis, are typically absent.