Bacterial tracheitis (pseudomembranous cereal)

Bacterial tracheitis (pseudomembranous cereal) is a bacterial infectious disease with localization in the trachea.

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What causes a bacterial tracheitis?

Bacterial tracheitis is a rare disease that occurs in children of any age. The most common tracheitis is caused by Staphylococcus aureus, pre-moly Streptococcus group A and Haemophilus influenzae type b.

Symptoms of bacterial tracheitis

Tracheitis begins acutely and is characterized by a stridor, a high fever, and also frequent abundant purulent discharge. As in patients with epiglotitis, the child may have severe intoxication and respiratory failure, which can progress rapidly and require intubation of the trachea.

Diagnosis of bacterial tracheitis

The diagnosis is assumed clinically and confirmed with direct laryngoscopy, in which there is a purulent discharge and inflammation in the subpharyngeal region with a rough, purulent film, or when the neck is X-rayed in the lateral projection, in which a narrowing of the subpharyngeal region is detected, which may be uneven, in contrast to the symmetrical cone-shaped narrowing, characteristic of croup.

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Treatment of bacterial tracheitis

Treatment of tracheitis in severe cases is the same as treatment of epiglottitis; if possible, intubation of the trachea should be performed. Intubation of the trachea under controlled conditions should be performed by a person who has experience working with the respiratory tract in children. The starting antibiotic should act on S. Aureus, streptococci, H. Influenzae type b; empirically may be prescribed cefuroxime or an equivalent antibiotic for intravenous administration, however, if methicillin-resistant staphylococcus prevails in the region, vancomycin should be used. Treatment of tracheitis in children in critical condition should be conducted under the guidance of a consultant who is well aware of local peculiarities of sensitivity to antibacterial therapy. When the causative agent becomes known, the spectrum of action narrows and the treatment lasts 10 days or longer.

What is the prognosis of a bacterial tracheitis?

Complications of tracheitis include bronchopneumonia, sepsis and inflammation of the retropharynx or anapharyngopharyngeal abscess. Secondary pharyngeal stenosis, associated with prolonged intubation of the trachea, is rare. Most of the children who received proper treatment, tracheitis does not leave any consequences.