Bacterial tracheitis: Difference between revisions
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== Background == | == Background == | ||
#Bacterial infection of tracheal epithelium | #Bacterial infection of tracheal epithelium | ||
##Often secondary infection after viral illness | ##Often secondary infection after viral illness | ||
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== Diagnosis == | == Diagnosis == | ||
#Severely ill child, starts out as viral prodrome | #Severely ill child, starts out as viral prodrome | ||
##Followed by stridor, resp distress, and copious purulent secretions | ##Followed by stridor, resp distress, and copious purulent secretions | ||
| Line 14: | Line 12: | ||
##Severe decompensation, high fever, purulent secretions help differentiate | ##Severe decompensation, high fever, purulent secretions help differentiate | ||
##May also have concomitant pneumonia | ##May also have concomitant pneumonia | ||
== Workup == | == Workup == | ||
#Clinical diagnosis | #Clinical diagnosis | ||
#XR neck may show subglottic narrowing with ragged tracheal epithelium | #XR neck may show subglottic narrowing with ragged tracheal epithelium | ||
#CXR may show concominant pneumonia | #CXR may show concominant pneumonia | ||
#Emergent bronchoscopy is diagnostic and therapeutic | #Emergent bronchoscopy is diagnostic and therapeutic | ||
== Treatment == | == Treatment == | ||
#Intubation, emergent, usually necessary | #Intubation, emergent, usually necessary | ||
#Bronchoscopy to confirm dx, rule out supraglottic pathology | #Bronchoscopy to confirm dx, rule out supraglottic pathology | ||
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== Disposition == | == Disposition == | ||
#ICU admit | #ICU admit | ||
#Often require prolong intubation, 4-5 days | #Often require prolong intubation, 4-5 days | ||
== Source == | == Source == | ||
Rosen | Rosen | ||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:ID]] | [[Category:ID]] | ||
Revision as of 02:56, 26 November 2011
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
Diagnosis
- Severely ill child, starts out as viral prodrome
- Followed by 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
Workup
- 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
Source
Rosen