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At least 55 records · Page 3Linked to original sources
PubMed1985

Bacterial tracheitis, diagnosis and treatment.

During a 22-month period, 5 children, 6-13 months of age, presented with an acute obstructive upper airway infection which resembled both croup and epiglottitis. All 5 failed to respond to standard treatment for croup, including aerosolized racemic epinephrine. In all patients, direct laryngoscopy revealed minimal or no change in the epiglottis and aryepiglottic folds but severe subglottic swelling and copious purulent tracheal secretions. Gram stains of the purulent secretions revealed many polymorphonuclear leukocytes with gram-positive cocci (3 patients) and small gram-negative rods (2 patients). Cultures subsequently confirmed the presence of S. Aureus and H. Influenzae. Initial therapy for all patients included endotracheal intubation, antibiotic therapy for both S. Aureus and H. Influenzae and frequent tracheal suctioning. Hospitalization varied from one to 3 weeks. We reported findings in these patients because: the initial diagnosis was unclear due to confusion caused by clinical features common to both croup and epiglottitis and bacterial tracheitis requires a prompt accurate diagnosis and aggressive antibiotic and airway management in order to prevent unnecessary morbidity and mortality.

Airway Obstruction↗
PubMed2001

[Laryngitis revealing bacterial tracheitis in a five-year-old child].

CASE REPORT: We report the case of a five-year-old boy with clinical features of croup and left lower lobe pneumonia. Response to inhaled adrenaline and dexamethasone was incomplete and he developed respiratory distress. Direct laryngoscopy performed in the operating room showed mild glottic and subglottic inflammation. On bronchoscopy, there was thick pus coming from the left lower lobe. He was intubated for three days and regular toilet brought back thick pus. Tracheal fluid culture grew Haemophilius influenzae. COMMENTS: We suggest that he had bacterial tracheitis but that the tracheal involvement was not prominent at the time of diagnosis. CONCLUSION: Laryngoscopy and bronchoscopy in specialized surroundings should be considered for each child with croup unresponsive to conventional treatment, especially in case of lower respiratory tract involvement.

Administration, Inhalation↗
PubMed1988

Bacterial tracheitis in a young adult.

A previously healthy young adult presented with inspiratory stridor and hoarseness but minimal dysphagia. Indirect laryngoscopy and lateral neck X-rays confirmed a diagnosis of membranous tracheitis. This responded to humidification, antibiotics and steroids. Secretions removed at direct laryngoscopy sent for culture grew Staphylococcus aureus. The literature is reviewed.

Adolescent↗
PubMed1998

Primary tuberculous tracheitis.

We report a case of primary tuberculous tracheitis in an otherwise healthy woman who presented with cough and stridor due to diffuse tracheal narrowing by tuberculous pseudomembranous lesion, which resolved completely with antituberculosis chemotherapy.

Antitubercular Agents↗
PubMedDate not supplied

An update on inflammatory disorders of the pediatric airway: epiglottitis, croup, and tracheitis.

Acute infections of the respiratory tract are common in pediatric patients. Respiratory disease is the leading cause of hospitalization in children less than 4 years of age and is responsible for many physicians' office and emergency department visits.(1) The severity of upper respiratory tract infection ranges from mild, self-limited disease to potentially life-threatening airway obstruction. The prepared clinician can often make a diagnosis based solely on the history and physical examination, using radiographs and laboratory examinations to aid in diagnosis when the clinical picture is unclear. At times, airway collapse is imminent, and the clinician must proceed directly to endoscopy for definitive diagnosis and airway protection. This article will discuss the pathogenesis, clinical presentation, and management of epiglottitis, croup, and bacterial tracheitis in the pediatric population.

Child↗
PubMed1998

Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit.

Bacterial tracheitis is characterized by acute upper-airway obstruction and purulent secretions within the trachea. Historically, affected children were young, stridorous, and toxic-appearing and required tracheal intubation, and morbidity and mortality were significant. Staphylococcus aureus was the most common organism involved. During the 14 months of this retrospective study, 46 children were admitted to the pediatric intensive care unit because of this diagnosis, and their medical records were reviewed. Compared with those in previous reports, children in this study were older (mean +/- standard error of the mean [SEM], 69.3 +/- 6.8 months) and less toxic. Only 26 (57%) of 46 patients required tracheal intubation. Intubated patients were significantly younger than nonintubated patients (mean +/- SEM, 46.9 +/- 6.5 vs. 98.9 +/- 9.9 months). Moraxella catarrhalis was identified in 12 (27%) of 45 bacterial respiratory cultures, while influenza A virus was recovered from 18 (72%) of 25 viral respiratory cultures. There were no major complications. This series represents the largest reported cohort of patients with this condition and suggests an epidemiological change toward a less morbid condition.

Adolescent↗
PubMedDate not supplied

Necrotizing tracheitis caused by Corynebacterium pseudodiphtheriticum: unique case and review.

The occasional pathogenicity of nondiphtheria corynebacteria in both immunocompetent and immunocompromised individuals is now well established. Previously described sites of infection include heart valves, wounds, urinary tract, and lungs. This report of necrotizing tracheitis caused by Corynebacterium pseudodiphtheriticum illustrates the widening spectrum of infections caused by these organisms. A 54-year-old man developed respiratory distress and symptoms of upper airway obstruction unresponsive to inhaled bronchodilators, systemic corticosteroids, or intravenous erythromycin. A spirometry flow-volume loop demonstrated fixed upper airway obstruction. Fiberoptic bronchoscopic examination revealed a circumferential inflammatory process partially occluding the tracheal lumen. Gram staining revealed gram-positive rods typical of corynebacteria, and cultures of tracheal tissue yielded C. pseudodiphtheriticum resistant to erythromycin and clindamycin. There was no clinical or laboratory evidence for exotoxin or cell-associated toxins. Treatment with intravenous penicillin resulted in resolution of the inflammatory process and eradication of the organisms, as assessed by subsequent cultures.

Airway Obstruction↗
PubMed1996

Staphylococcal tracheitis, pneumonia, and adult respiratory distress syndrome.

A child initially seen in the emergency department with respiratory distress was diagnosed with viral laryngotracheitis and discharged home on oral steroids. She returned the following day without abatement of her symptoms and was admitted with upper airway obstruction and pneumonia. Bacterial tracheitis was diagnosed when the tracheal aspirate grew a pure culture of Staphylococcus aureus. Hemodynamic instability and severe parenchymal lung disease ensued from septic shock and adult respiratory distress syndrome requiring inotropic support and assisted ventilation. Oscillatory ventilation was instituted when the patient failed conventional ventilation.

Child, Preschool↗
PubMed1993

Necrotizing squamous metaplasia in herpetic tracheitis following prolonged intubation: a lesion similar to necrotizing sialometaplasia.

In the last year we have encountered three cases of clinically inapparent herpes simplex virus (HSV) tracheitis in biopsies from patients undergoing tracheostomy following prolonged intubation. The diagnosis was based on finding characteristic inclusion-bodies on haematoxylin and eosin stained sections and was confirmed by immunohistochemical staining of infected cells with antibodies to HSV. A prominent mononuclear infiltrate, originally described in HSV oesophagitis, was recognized in two cases. Diffuse squamous metaplasia of both surface and glandular epithelium adjacent to necrotic ulcerated areas was evident in all three cases. Where extensive, the necrotizing squamous metaplasia of the glandular/ductal component was similar to necrotizing sialometaplasia of salivary glands, and likewise simulated squamous or mucoepidermoid carcinoma.

Adult↗
PubMedDate not supplied

Obstructive, granulomatous tracheitis caused by Onchocerca sp. in a dog.

A 3-year-old spayed female dog was admitted with a history of episodes of dyspnoea and coughing. Severe tracheal stenosis was found on radiography. The dog died during an episode of refractory dyspnoea. Necropsy revealed an obstruction of the thoracic part of the trachea because of a chronic granulomatous inflammation protruding into the tracheal lumen. Histological examination revealed nematodes, which were identified as Onchocerca sp. according to their morphological characteristics. In contrast to the common ocular manifestation in dogs, obstructive tracheitis caused by Onchocerca infection has not been reported before.

Animals↗
PubMedDate not supplied

Outbreak of mycotic tracheitis in domestic fowl.

An outbreak of mycotic tracheitis was observed in 8000 2-month-old, female White Leghorn birds. The birds were showing difficult respiration and there was mortality of 7-8 birds daily in the flock. On post-mortem examination of the affected birds, the trachea was found to be occluded with a white caseous mass. Microscopically hyphae were found invading the tracheal epithelium, cartilage and serosal layer along with infiltration of macrophages and lymphocytes. Aspergillus fumigatus was isolated in pure culture from the trachea. The birds responded to oral copper sulphate treatment. The ubiquitous occurrence of the organism and the conditions of the harvesting season have been found to be responsible for the outbreak of the disease.

Animals↗
PubMed1979

Tracheitis in sheep after oral administration of a mineral supplement.

Outbreaks of illness and deaths in sheep after the concurrent administration of a cobalt, copper and zinc mineral supplement and laevamisole are described. Clinical illness was characterised by profound dyspnoea and inability to exercise. The consistent postmortem finding was severe, necrotising tracheitis with partial occlusion of the airway. This lesion was reproduced experimentally by intratracheal administration of the mineral supplement dissolved in one particular formulation of laevamisole but not in water or another preparation of laevamisole. Further experiments revealed that combined zinc sulphate and copper sulphate dissolved in the particular formulation of laevamisole would produce the tracheal lesions.

Animals↗
PubMed1990

Aspergillus fumigatus as a cause of mycotic tracheitis in a chicken.

An unusual case of mycotic tracheitis in a young chick caused by Aspergillus fumigatus was recorded from Anand, India, during 1987. The pathogen was demonstrated in the tracheal exudate by potassium hydroxide technique and also recovered from the trachea on Sabouraud dextrose agar at 37 degrees C. The characteristic hyphae of Aspergillus spp. were demonstrated in tracheal mucosa in histopathological sections stained by periodic acid Schiff method. Interestingly, the lesions were confined only to the trachea. Environmental investigations established the source of infection in the farm where the litter was highly contaminated with A. fumigatus.

Animals↗
PubMed2003

Characterization of a herpesvirus associated with tracheitis in Gouldian finches (Erythrura [Chloebia] gouldiae).

Severe tracheitis and bronchitis were identified in two fatal cases of respiratory disease affecting a flock of Gouldian finches (Erythrura [Chloebia] gouldiae). Intranuclear inclusion bodies in epithelial cells of the upper respiratory tract were identified in samples from two birds. Electron microscopic examination showed that the inclusions consisted of viral particles consistent in appearance with Herpesviridae. Degenerate PCR primers targeting a conserved region of the herpesviral-DNA-dependent DNA polymerase were used to amplify a region of DNA isolated from tissues with lesions from each animal. Nucleotide sequencing of the PCR products yielded identical viral sequences that were distinct from known herpesviruses. An analysis of sequence homology indicated that these gene segments appear to belong to a member of the subfamily Alphaherpesvirinae.

Animals↗
PubMed1996

Ulcerous tracheitis and mucus ball formation: a nearly fatal complication of a transtracheal oxygen catheter.

A transtracheal oxygen catheter may be superior to a nasal cannula. In particular, transtracheal oxygen therapy (TTOT) shows a 50% saving of oxygen consumption, a significant reduction of energy cost of breathing, and an improved patient compliance due to esthetic benefits and avoidance of mucosal injury by a nasal cannula. Most complications so far reported have been of minor clinical importance and could be treated easily. However, using the SCOOP technique, a serious complication has recently occurred in 1 of our patients. Soon after starting TTOT with a SCOOP-1 catheter he developed an ulcerous tracheitis and a severe tracheal obstruction by a mucus ball. To prevent further respiratory emergencies TTOT finally was stopped and the catheter replaced again by a nasal cannula. There is evidence that tracheal injury as well as the formation of mucus balls may be promoted by regular brushing the preliminary SCOOP-1 catheter which usually is left in place during the first weeks. As a result of this harmful experience, we recommend to reconsider carefully the indication for TTOT in patients with copious bronchial secretions and to avoid cleaning of the SCOOP-1 catheter with the rigid wire brush.

Aged↗
PubMed1997

Nosocomial pneumonia and tracheitis in a pediatric intensive care unit: a prospective study.

We conducted a prospective study in the multidisciplinary pediatric intensive care unit (pediatric ICU) of a tertiary-care university hospital in order to determine the incidence, risk markers, risk factors, and complications related to bacterial nosocomial pneumonia (BNP) and tracheitis (BNT) in children. A cohort of 1,114 consecutive admissions to the pediatric ICU was enrolled over a 56-wk period; 154 cases were excluded mostly (75%) because they already had a respiratory infection at entry. The final sample included 960 admissions (831 patients). Diagnosis of BNP or BNT was based on Centers for Disease Control of Atlanta criteria using a consensus method involving three experts, who also attributed complications to BNP and BNT. A total of 29 BNP and BNT (3.0%; 95% CI: 1.1 to 4.1%) were diagnosed (BNP: 1.2%, 95% CI: 0.7 to 1.9%; BNT: 1.8%, 95% CI: 0.8 to 2.6%). Three factors were retained by multivariate analysis as independent risk factors or markers for BNP (immunodeficiency, immunosuppression, and neuromuscular blockade), and two for BNT (head trauma and respiratory failure). Gram-negative bacteria and Staphylococcus aureus were the microorganisms most frequently found in the tracheal aspirates. Prescription of antibiotics was commonly attributable to BNP (75%) and BNT (59%). Death, as well as multiple organ system failure, resulted from BNP in 8% of cases, but never from BNT. In BNT, the reintubation rate was 24%. Nosocomial bacterial respiratory infections are rare in critically ill children. However, BNP causes significant complications, and more attention should be focused on BNT in the critically ill child.

Child, Preschool↗
PubMed1990

Central airway obstruction due to cytomegalovirus-induced necrotizing tracheitis in a patient with AIDS.

Cytomegalovirus (CMV) infection in patients with the acquired immunodeficiency syndrome (AIDS) can present as either disseminated disease, pneumonitis, retinitis, gastroenteritis, neuropathy, or a subclinical infection. We report a patient whose initial manifestation of CMV infection was severe central airways obstruction due to necrotizing tracheitis. At bronchoscopy, the lesion appeared deeply ulcerated, distinctly different from previously described airway lesions in patients with AIDS. Mucosal biopsies showed characteristic intranuclear and intracytoplasmic inclusions and cultures yielded only CMV. The patient responded partially to ganciclovir, steroids, and antibiotics against suspected anaerobic superinfection but died as a result of central nervous system disease believed due to toxoplasmosis or lymphoma. CMV infection of the upper airway should be considered in the patient with AIDS presenting with atypical cough or stridor and ulcerated endobronchial lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Tracheal stenosis and failure to wean from mechanical ventilation due to herpetic tracheitis.

A 64-year-old man with chronic obstructive pulmonary disease presented with pneumococcal pneumonia that progressed to respiratory failure within one week, requiring mechanical ventilation. Despite a low minute ventilation and clear chest roentgenogram, multiple weaning attempts failed. Bronchoscopy revealed significant narrowing of the distal trachea with erythema, edema, and ulceration of the mucosa. Cytology of tracheal washings was consistent with herpes simplex virus, and the patient was successfully extubated following treatment with intravenous acyclovir. Bronchoscopy following acyclovir therapy demonstrated resolution of the inflammation and narrowing. Herpetic tracheitis is a rarely recognized reversible cause of tracheal stenosis, especially in a nonimmunocompromised patient. It should be suspected in patients without an obvious cause of failure to wean from mechanical ventilation, and can be successfully treated with acyclovir.

Bronchoscopy↗