Bacterial tracheitis

(Redirected from Bacterial Tracheitis)


  • Bacterial infection of tracheal epithelium
  • Peak age is 3-5 years old
    • Occurs throughout childhood and adulthood

Clinical Features

  • Severely ill child, starts out as viral prodrome
  • Difficult to differentiate from croup and epiglotitis
    • Severe decompensation, high fever, purulent secretions help differentiate
    • May also have concomitant pneumonia
  • May have been treated with racemic epinephrine and steroids for croup, with no clinical improvement

Differential Diagnosis

Pediatric stridor




  • Clinical diagnosis
  • Gram stain with predominance of one organism, differentiating from colonization
  • XR neck may show subglottic narrowing with ragged tracheal epithelium
  • CXR may show concomitant pneumonia
  • Emergent bronchoscopy is diagnostic and therapeutic


  • Intubation, emergent, usually necessary
  • Bronchoscopy to confirm diagnosis, rule out supraglottic pathology
  • Antibiotics[1]
    • Third generation cephalosporin (cefotaxime or ceftriaxone)
    • PLUS MRSA coverage, options below depending on prevalence of CA-MRSA


  • Admit to ICU
  • Often require prolonged intubation (4-5 days)


  • Toxic shock syndrome
  • Septic shock
  • Renal failure
  • Postintubation pulmonary edema
  • ARDS
  • Residual subglottic stenosis

See Also


  1. Bacterial Tracheitis - Treatment and Management. Medscape.


Ross Donaldson