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Association of cilia-associated respiratory (CAR) bacillus with natural chronic tracheitis in goats.

A histological, histochemical and immunohistological study of the respiratory tract of 83 slaughtered goats (50 adults and 33 kids) is described. Cilia-associated respiratory (CAR) bacillus was detected by means of the Warthin Starry method in the tracheal epithelium of seven (21.2%) of the kids and 16 (32%) of the adult goats. A chronic diffuse tracheitis characterized by mixed lymphocyte and plasma-cell infiltration was found in all seven kids and in 17 adults, including the 16 infected with the CAR bacillus. Although not proved, it is possible that the CAR bacillus caused the chronic tracheitis. Immunohistochemical results suggested that the caprine CAR bacillus was closely related to the rabbit CAR bacillus.

Animals↗

Bacterial tracheitis as a complication of tonsillectomy and adenoidectomy.

We describe two patients in whom bacterial tracheitis developed shortly after elective tonsillectomy and adenoidectomy. Bacterial tracheitis has not previously been reported in this clinical setting. Prompt recognition is essential if a fatal outcome is to be avoided. The cause remains uncertain, but the outcome is good if timely treatment is instituted.

Adenoidectomy↗

Tracheitis: the 'other' cause of upper airway obstruction.

A 22-year-old woman presented to an ear, nose, and throat clinic with an upper respiratory infection and sudden stridorous respirations. Aerosolized isoethrane therapy was beneficial and fiber-optic nasolaryngoscopy revealed a normal supraglottis and purulent intratracheal secretions. Secretions were cultured and grew Staphylococcus aureus and alpha hemolytic Streptococcus. IV cefazolin was initiated and the patient recovered without sequelae. This case illustrates a rare cause of upper airway obstruction, tracheitis. Tracheitis has been found in the pediatric literature. This is the first adult case reported in the literature.

Adult↗

Membranous tracheitis following endotracheal intubation.

In this study, four patients with membranous tracheitis following endotracheal intubation are presented. Possible causes for the development of the condition were mostly related to subglottic epithelial trauma caused by the pressure of the cuff of the tube for a long time on the mucosa and the drying effect of atropine. The literature concerning the development of membranous tracheitis in previous studies is also presented.

Adolescent↗

Fulminant Branhamella catarrhalis tracheitis.

Branhamella catarrhalis, a well known commensal of the normal respiratory flora, is being increasingly implicated as an aetiological agent in various acute respiratory and non-respiratory infections. B. catarrhalis has demonstrated a particular predilection for turning pathogenic in the immunocompromised host. Bacterial tracheitis, presenting as an acute airway obstruction, is commonly caused by Staphylococcus aureus and Haemophilus influenzae. The unusual occurrence of a fulminant B. catarrhalis bacterial tracheitis in a previously normal and healthy Indian child is the subject of this communication.

Humans↗

Herpetic tracheitis and brachial plexus neuropathy in a child with burns.

Herpetic tracheobronchitis is a well-recognized clinical entity that most commonly occurs in immunocompromised patients, including patients with burns. Although the diagnosis of herpetic tracheobronchitis is usually not made until postmortem examination, the presence of the condition can be established when histologic specimens of a patient with upper airway obstruction are studied. In this article, a case is described in which a child developed herpetic tracheitis after undergoing elective intubation after the grafting of burns of the face, neck, and upper extremity. The tracheitis resulted in severe upper airway obstruction that required tracheal dilatation and sequential bronchoscopic excisions of granulation tissue. The patient also developed a brachial plexus neuropathy that was most likely related to herpetic infection.

Brachial Plexus↗

Bacterial tracheitis in Down's syndrome.

Four children with Down's syndrome and bacterial tracheitis are described. In three the infection was due to Haemophilus influenza. In patients with Down's syndrome presenting with stridor tracheitis should be considered and appropriate treatment started.

Child↗

Bacterial tracheitis--two-year experience.

Inflammatory illnesses of the pediatric airway cause significant morbidity and mortality. Bacterial tracheitis is a distinct entity with features common to both croup and epiglottitis. Ten patients between the ages of 3 months and 12 years were treated at Children's Hospital, Boston, MA., for bacterial tracheitis. The clinical presentation and medical management is discussed. Seven of the patients required both direct laryngoscopy and bronchoscopy; one patient required urgent intubation; and one patient required indirect laryngoscopy. In one patient the diagnosis was based on clinical and radiographic findings in conjunction with tracheal aspirates. Seven of the 10 patients did well with aggressive medical management. Three patients required endotracheal intubation. No patient required tracheotomy, and there were no cardiopulmonary arrests. It is of particular interest that although the patients in this series presented in a manner similar to that of patients in other published series, the management is significantly different and the overall outcome is significantly better.

Bacterial Infections↗

Focal transmural necrotic tracheitis in commercial meat turkeys.

This report describes an unusual presentation of severe focal necrotic tracheitis in a flock of 8-wk-old commercial turkeys. The flock was kept on a range that is located near a cotton field. The cotton field had been chemically defoliated 2 wk before the birds were submitted for necropsy. At necropsy, most of the birds had a 1-cm, yellow-white constricture in the upper third of the trachea at which the lumen was partially occluded by necrotic tissue. Microscopically, there was severe, transmural necrosis with an accumulation of inflammatory exudate in the tracheal lumen and numerous bacteria within the necrotic debris, mucosa, and lamina propria. Mixed bacteria were isolated from the trachea. No viruses were detected. Neither abnormal heavy metal concentrations in the liver nor paraquat in the respiratory tract were detected. The exact cause of this severe, necrotic tracheitis was not determined. Based on the clinical history and laboratory findings, it was concluded that a combination of a toxic irritant, possibly an aerosolized cotton defoliant, and bacterial infections were likely the cause of this lesion.

Animals↗

[Bacterial tracheitis due to Haemophilus influenzae].

We present a case of bacterial tracheitis in a 6.5 year old girl. Clinical signs and symptoms consisted of severe croup with high grade fever, which were preceded by upper respiratory tract prodrome. Initial treatment with steroids and nebulized epinephrine was unsuccessful. The patient was intubated a few hours after admission. Thick purulent secretions emerging from the trachea and the normal appearance of the epiglottis suggested the diagnosis of bacterial tracheitis, which was confirmed by isolation of Haemophilus influenzae in the culture of the tracheal secretions. The patient was administered a 14 day course of endovenous ceftriaxone and was kept on mechanical ventilation for 7 days. Fever and purulent tracheal secretions continued for the next 5 days. After 48 hours without these signs, laryngotracheobronchoscopy ruled out residual obstruction. Extubation was successfully performed. Fourteen days later physical examination showed no abnormalities and the patient was discharged. No complications were found during followup. The clinical, diagnostic and therapeutic aspects of this potentially life threatening entity that should taken into account in the differential diagnosis of severe croup are discussed.

Ceftriaxone↗

[Bacterial tracheitis as the cause of acute respiratory insufficiency in 2 teenagers].

A 13-year-old girl and a 12-year-old boy developed acute respiratory insufficiency caused by an upper airway obstruction, which necessitated intubation and mechanical ventilation. Cultures from throat swabs from the girl and boy yielded Haemophilus parainfluenzae and Streptococcus pneumoniae, respectively. Diagnoses of bacterial tracheitis were confirmed by tracheoscopy and both children were treated with antibiotics. After 11 and 4 days of mechanical ventilation, respectively, they were successfully extubated. No further complications were encountered. Bacterial tracheitis is a rare but significant cause of upper airway obstruction in children.

Acute Disease↗

Conjunctivitis, tracheitis, and pneumonia associated with herpesvirus infection in green sea turtles.

Fourteen juvenile (15- to 20-month-old) green sea turtles (Chelonia mydas), representative of a group of sea turtles with clinical signs of respiratory tract disease, were euthanatized and submitted for necropsy. Macroscopically, lesions included periglottal necrosis, tracheitis with intraluminal caseous and laminated necrotic debris, and severe pneumonia. Several turtles had caseous conjunctival exudate covering the eyes. Microscopically, the turtles had fibrinonecrotic inflammation around the glottal opening, tracheitis, and severe bronchopneumonia and interstitial pneumonia. In multifocal areas, periglottal and tracheal epithelial cells adjacent to areas of necrosis had hypertrophic nuclei with amphophilic intranuclear inclusions. A mixed population of primarily gram-negative microorganisms was isolated from the tracheal and glottal lesions. Attempts at viral isolation in cultures of green sea turtle kidney cells resulted in the development of cytopathic effects characterized by giant cell formation and development of intranuclear inclusions. Using electron microscopy, intranuclear viral particles (88 to 99 nm in diameter) were seen in inclusion-containing tracheal and glottal epithelial cells and infected green sea turtle kidney cells; particles were consistently seen enveloping from nuclear membranes, and mature particles (132 to 147 nm) were found in the cytoplasm. On the basis of size, conformation, location, and presence of an envelope, the particles most closely resembled those of herpes-viruses.

Animals↗

Bacterial tracheitis.

During a 14-month period, eight infants and children were observed with an acute, infectious, upper airway obstructive disease with features common to both croup and epiglottitis. We have termed this distinct entity "bacterial tracheitis." All patients failed to respond to treatment for croup, including racemic epinephrine delivered by intermittent positive-pressure breathing. Direct laryngoscopy consistently revealed a normal epiglottis and aryepiglottic folds but marked subglottic mucosal edema. Tracheal suctioning yielded copius mucopus below the subglottic swelling. Gram stain of this material corroborated subsequent cultures: Staphylococcus aureus, six; group A Streptococcus, one; and Haemophilus influenzae (not typed), one. All patients required periodic tracheal suctioning for relief of upper airway obstruction. Six patients required endotracheal intubation; one required a tracheostomy. Bacterial tracheitis should be considered in the differential diagnosis of a young child with a croup-like illness that is refractory to conventional therapy.

Bacterial Infections↗

Bacterial tracheitis: recognition and treatment.

Bacterial tracheitis is a rare, life-threatening form of upper airway obstruction usually seen in children. It is often confused with other forms of upper airway obstruction and must be distinguished from viral croup and epiglottitis. The mainstay of treatment is establishing and maintaining an artificial airway, thus clearing the trachea of the mucopurulent exudate which has accumulated. It is wise for the physician to maintain a high index of suspicion for bacterial tracheitis especially in those children with fever and an upper airway obstruction who fail to exhibit the typical clinical features of croup or epiglottits.

Bacterial Infections↗

Avian infectious laryngo-tracheitis in Egypt. I. Epidemiology, virus isolation and identification.

Serious outbreaks of haemorrhagic tracheitis in poultry induced by infectious laryngo-tracheitis virus (ILTV) have been recorded in Egypt for the first time. The disease occurred in different localities during late 1982 and early 1983. The associated drop in egg production ranged between 5% and 35% and there was a mortality rate which ranged from 0.05% to 19.8%. The causal virus was isolated on the chorioallantoic membrane (CAM) of developing chicken embryos where it induced large yellowish-white pock lesions, 3-4 mm in diameter, by the fifth or sixth day post-inoculation. It was non-lethal to the inoculated embryos. It grew also with cytopathic effect (CPE) on the CER cell line. The CPE was characterized by syncytial formation and intranuclear inclusions. Chickens experimentally inoculated with the virus developed respiratory signs and 14 of 20 birds died with subsequent virus re-isolation. The isolated virus was unable to agglutinate chicken red cells and it was precipitated and partially neutralized by reference serum to ILTV. Viral antigen was detected by the indirect fluorescent antibody technique in tracheal smears obtained from naturally and experimentally infected birds. This is the first report of the isolation of ILTV in Egypt.

Animals↗

Bacterial tracheitis.

During a two-year period, 17 children were brought to the St Paul Children's Hospital with the clinical features of croup, unresponsive to conventional therapy; 12 of these were seen during a two-month outbreak of parainfluenza virus type 1 that occurred in the community. Bronchoscopy showed copious purulent tracheal secretions. Cultures of transbronchoscopic aspirates were positive for bacterial organisms, the most common being Staphylococcus aureus (six of 17) and alpha-hemolytic Streptococcus (seven of 17). Four of these children, all treated conservatively with observation and/or endotracheal intubation, suffered a cardiorespiratory arrest, and two of them died. In contrast, one of 13 children who underwent tracheostomy died. Bacterial tracheitis clinically resembles viral croup, but carries a significant morbidity and mortality. Bronchoscopy documenting the presence of copious endotracheal pus and prompt tracheostomy may reduce the complications of this disease.

Bronchoscopy↗

Bacterial tracheitis: a resurfacing airway emergency.

Children presenting to the emergency department with symptoms of upper respiratory distress represent a diagnostic and therapeutic challenge. An acute onset associated with fever most often indicates epiglottitis or laryngotracheobronchitis. Presented here is a case of acute bacterial tracheitis, a life-threatening entity that apparently has reemerged recently. Prompt recognition is essential but can be difficult. Historical perspectives, clinical features, and pitfalls in diagnosis and management are discussed.

Child↗

A novel Mycoplasma sp. associated with proliferative tracheitis and pneumonia in a Burmese python (Python molurus bivittatus).

Proliferative lymphocytic tracheitis and pneumonia were observed histologically in the respiratory tract of a captive Burmese python (Python molurus bivittatus). A mycoplasma species was isolated from the respiratory tissue. Polymerase chain reaction analysis of the 16S rRNA gene sequence of the isolate showed 0.90 similarity to Mycoplasma agassizii, an organism previously shown to cause respiratory disease in reptiles. Based on these findings, a novel Mycoplasma species was suspected to be the causative agent of respiratory disease in this snake.

Animals↗