Bacterial Tracheitis Symptoms causes and treatment

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Tracheitis is infection and inflammation of the trachea, Trachea also called breathing tube or windpipe. • it can occur in isolation, or as a post-viral respiratory infection complication. • Bacterial tracheitis, also known as bacterial croup or laryngotracheobronchitis. • tracheitis is a potentially lethal infection of the subglottic trachea for kids. • Bacterial tracheitis should be considered in the differential diagnosis of any child with acute upper airway obstruction. • Signs and symptoms include: • Increasing deep or barking croup cough following a recent upper respiratory infection, • Crowing sound when inhaling (inspiratory stridor). hoarseness, cough and tachypnea. • 'Scratchy' feeling in the throat, • Chest pain, • Fever, • Tracheitis is often a secondary bacterial infection preceded by a viral infection affecting children, most commonly under age six. • It can also be rarely seen spontaneously in the adult population, and tracheostomy-dependent patients of any age. • When person gets flue or common cold, viruses easy can damage tracheal mucosa, and it creates environment for bacterial infection and bacterial growth. • Children with bacterial tracheitis usually present with a history of a viral respiratory illness, such as croup. Rhinorrhea, cough, fever and sore throat are frequently reported symptoms that may be present for up to one week before presentation. • An important clinical distinction between bacterial tracheitis and the more common clinical entity, viral croup, is the poor response to conventional medical therapy of croup, including administration of racemic epinephrine and systemic corticosteroids. Children with bacterial tracheitis also generally appear more toxic and have higher body temperatures. • Most common bacterias which can cause bacterial tracheitis are: Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus [MRSA]), Streptococcus pneumoniae, Streptococcus pyogenes, Moraxella catarrhalis, Haemophilus influenzae type B (HiB), Haemophilus influenzae (non-typeable), and less commonly, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia, and anaerobic organisms. • The only definitive way to diagnose bacterial tracheitis is by direct visualization of the trachea via bronchoscopy; however, this may not be required in all cases. • The diagnosis of bacterial tracheitis is primarily clinical via a thorough history and physical examination. As discussed above, patients may appear febrile, dyspneic, hoarse, stridulous, septic or toxic-appearing, and in respiratory distress. Trial with nebulized epinephrine and glucocorticoids will typically fail to show improvement in the patient's clinical course. • Laboratory investigation with white blood cell count is variable and nonspecific. • Leukocytosis, as well as mild leukopenia, are commonly seen. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are also nonspecific but are estimated to be elevated in 68% of patients. Blood cultures are rarely positive; • Radiographic images of the lateral or anteroposterior neck can show subglottic or tracheal narrowing, typical of that seen with croup. • overall, chest radiographs are of poor diagnostic value. • Laryngoscopy and bronchoscopy allow visualization of the infected airway and will demonstrate a normal or mildly erythematous epiglottis and an erythematous, edematous trachea with thick mucopurulent exudates. • If bronchoscopy is performed, specimens for gram stain and cultures should be obtained during this time. Less severe cases not requiring endoscopy or endotracheal intubation can obtain cultures via a sputum sample. In practice, this can be difficult in children. • Diagnosis of bacterial tracheitis can be difficult given its rarity, in addition to more prevalent diseases with similar presentations. • Treatment of bacterial tracheitis includes a prompt assessment for airway compromise first. The need for intubation is common with reported rates ranging from 38% to 100% of patients in various studies. • third generation cephalosporin agent combined with a beta-lacta-mase resistant penicillin (eg, cloxacillin) is appropriate for first line therapy. • If the anaerobic culture is positive, additional or alternative therapy such as clindamycin or metronidazole may be considered, particularly in a child who is not responding to first line therapy. • By Persian Poet Gal at the English-language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index... • By © Nevit Dilmen, CC BY-SA 3.0, https://commons.wikimedia.org/w/index... • By Hariadhi - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index... • By BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). quot;Medical gallery of Blausen Medical 2014 quot;. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index...

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