Bacterial tracheitis: Difference between revisions
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== Background == | == Background == | ||
*Bacterial infection of tracheal epithelium | |||
**Often secondary infection after viral illness | |||
**S. Aureus most common, also strep spp, H. Influenza and anaerobes | |||
*Peak age is 3-5 years old | |||
**Occurs throughout childhood and adulthood | |||
== | == Clinical Features== | ||
*Severely ill child, starts out as viral prodrome | |||
**Followed by inspiratory and expiratory stridor, resp distress, and copious purulent secretions | |||
*Difficult to differentiate from croup and epiglottis | |||
**Severe decompensation, high fever, purulent secretions help differentiate | |||
**May also have concomitant pneumonia | |||
== | ==Differential Diagnosis== | ||
== Diagnosis== | |||
*Clinical diagnosis | |||
*XR neck may show subglottic narrowing with ragged tracheal epithelium | |||
*CXR may show concominant [[Pneumonia]] | |||
*Emergent bronchoscopy is diagnostic and therapeutic | |||
== Treatment == | == Treatment == | ||
*Intubation, emergent, usually necessary | |||
*Bronchoscopy to confirm dx, rule out supraglottic pathology | |||
*Antibiotics | |||
**third gen cephalosporin and vanco/clinda | |||
== Disposition == | == Disposition == | ||
*ICU admit | |||
*Often require prolong intubation, 4-5 days | |||
==See Also== | |||
== References == | |||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Pulm]] | [[Category:Pulm]] | ||
Revision as of 19:30, 11 May 2015
Background
- Bacterial infection of tracheal epithelium
- Often secondary infection after viral illness
- S. Aureus most common, also strep spp, H. Influenza and anaerobes
- Peak age is 3-5 years old
- Occurs throughout childhood and adulthood
Clinical Features
- Severely ill child, starts out as viral prodrome
- Followed by inspiratory and expiratory stridor, resp distress, and copious purulent secretions
- Difficult to differentiate from croup and epiglottis
- Severe decompensation, high fever, purulent secretions help differentiate
- May also have concomitant pneumonia
Differential Diagnosis
Diagnosis
- Clinical diagnosis
- XR neck may show subglottic narrowing with ragged tracheal epithelium
- CXR may show concominant Pneumonia
- Emergent bronchoscopy is diagnostic and therapeutic
Treatment
- Intubation, emergent, usually necessary
- Bronchoscopy to confirm dx, rule out supraglottic pathology
- Antibiotics
- third gen cephalosporin and vanco/clinda
Disposition
- ICU admit
- Often require prolong intubation, 4-5 days