Which clinical history findings are characteristic of bacterial tracheitis?

Updated: Nov 26, 2018
  • Author: Sujatha Rajan, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Symptoms of bacterial tracheitis may be intermediately between those of epiglottitis and croup. Presentation is either acute or subacute.

  • In the classic presentation patients present acutely with fevers, toxic appearance, stridor, tachypnea, respiratory distress, and high WBC counts. Cough is frequent and not painful.

  • In a study by Salamone et al, a significant subset of older children (mean age, 8 y) did not have severe clinical symptoms. [10]

  • The prodrome is usually an upper respiratory infection, followed by progression to higher fever, cough, inspiratory stridor, and a variable degree of respiratory distress.

  • Patients may acutely decompensate with worsening respiratory distress due to airway obstruction from a purulent membrane that has loosened.

  • Patients have been reported to present with symptoms and signs of bacterial tracheitis and multiorgan failure due to exotoxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes in the trachea.

  • A high index of suspicion for bacterial tracheitis is needed in children with viral croup–like symptoms who do not respond to standard croup treatment or clinically worsen.


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