Summary about Disease
Tracheitis is an infection of the trachea, or windpipe. It is usually caused by bacteria, most commonly Staphylococcus aureus. It can cause severe breathing difficulties, particularly in young children, and requires prompt medical attention. Though most often bacterial, viral or fungal causes can occur as well, although less commonly. The inflammation and swelling of the trachea can obstruct airflow, leading to stridor (a high-pitched whistling sound during breathing), difficulty swallowing, and potentially life-threatening respiratory distress.
Symptoms
Barking cough (similar to croup)
Stridor (high-pitched whistling sound during breathing)
High fever (often higher than in croup)
Difficulty breathing or noisy breathing
Hoarseness
Difficulty swallowing (dysphagia)
Pain when swallowing
Thick, purulent (pus-filled) secretions
Restlessness or anxiety due to breathing difficulties
Retractions (pulling in of the skin between the ribs or above the collarbone during breathing)
Causes
Bacterial infection: Most commonly Staphylococcus aureus*. Other bacteria include *Moraxella catarrhalis*, *Haemophilus influenzae*, *Streptococcus pneumoniae*, and *Group A streptococcus*.
Viral infection: Less common, but can include parainfluenza viruses (the same viruses that cause croup), influenza viruses, and respiratory syncytial virus (RSV).
Fungal infection: Rare, but possible, especially in immunocompromised individuals.
Secondary Infection: Tracheitis may develop as a secondary infection following a viral upper respiratory infection (like a cold).
Medicine Used
Antibiotics: Essential for bacterial tracheitis. Commonly used antibiotics include intravenous (IV) antibiotics like vancomycin, clindamycin, or cefuroxime. The specific antibiotic chosen depends on local resistance patterns and the severity of the infection.
Pain relievers: Medications like acetaminophen or ibuprofen can help manage pain and fever.
Racemic Epinephrine: May be used to reduce airway swelling, similar to its use in croup.
Corticosteroids: Used to reduce inflammation.
Bronchodilators: Medications like albuterol may be used if bronchospasm (constriction of the airways) is present.
Intubation and Ventilation: In severe cases, the patient may require intubation (placement of a breathing tube) and mechanical ventilation to support breathing.
Is Communicable
Bacterial tracheitis itself is generally not considered directly communicable in the sense of easily spreading from person to person like a cold. However, the underlying viral or bacterial infections that can lead to tracheitis (such as staphylococcus aureus, influenza or parainfluenza) *are* often communicable. Therefore, good hygiene practices are essential to prevent the spread of the initial infection.
Precautions
Hand hygiene: Frequent handwashing with soap and water, or using alcohol-based hand sanitizer.
Avoid close contact: Minimize contact with individuals who are sick with respiratory infections.
Cough etiquette: Cover mouth and nose when coughing or sneezing.
Vaccination: Ensure vaccinations are up-to-date, including influenza and pneumococcal vaccines.
Avoid sharing personal items: Do not share utensils, cups, or towels.
Prompt medical attention: Seek immediate medical care if you or your child develops symptoms of tracheitis, especially difficulty breathing.
Monitor respiratory status: Closely monitor children with upper respiratory infections for signs of worsening respiratory distress.
How long does an outbreak last?
The duration of tracheitis depends on the cause, the severity of the infection, and how quickly treatment is started. With prompt and effective treatment, the acute phase of the illness typically lasts for several days to a week. Complete recovery can take longer, particularly if complications arise. Without treatment, the infection can rapidly worsen and become life-threatening.
How is it diagnosed?
Physical examination: Listening to breathing sounds, assessing for stridor and retractions.
Laryngoscopy or Bronchoscopy: Direct visualization of the trachea to identify swelling, inflammation, and purulent secretions. This is often the most definitive diagnostic test.
Blood tests: To look for signs of infection (elevated white blood cell count).
Blood culture: To identify the specific bacteria causing the infection.
Sputum or tracheal aspirate culture: To identify the specific bacteria, virus or fungi causing the infection.
X-ray or CT scan of the neck and chest: To assess the extent of the infection and rule out other conditions.
Timeline of Symptoms
The timeline can vary, but generally follows this pattern:
Initial phase (1-2 days): Symptoms may start like a typical upper respiratory infection (cold) with runny nose, mild cough, and low-grade fever.
Rapid progression (hours to days): The cough becomes more barking, stridor develops, fever spikes, and breathing difficulties worsen rapidly.
Severe phase (if untreated): Significant respiratory distress, exhaustion, cyanosis (bluish discoloration of the skin), and potentially respiratory failure.
Important Considerations
Tracheitis can progress rapidly and become life-threatening, especially in young children.
It is often misdiagnosed as croup initially.
Prompt diagnosis and treatment are crucial to prevent serious complications such as airway obstruction, respiratory failure, and septic shock.
Hospitalization is typically required for close monitoring and IV antibiotic administration.
Intubation and mechanical ventilation may be necessary in severe cases.
Even with treatment, complications can occur.
Distinguishing between tracheitis and other upper airway infections is critical for appropriate management.