Tracheitis bacterial

Tracheitis bacterial

Bacterial tracheitis is a severe, potentially life-threatening infection of the lower parts of the larynx and trachea, caused by a secondary bacterial infection after an acute respiratory viral infection. Frequency – About 2% of babies hospitalized for croup. The predominant age is from 3 weeks to 13 years. The predominant gender is male (2:1).


    • Staphylococcusaureus
    •  H. influenzae
    • Streptococcuspneu-moniae
    • Moraxella catarrhalis
    • Group A Streptococcus
    • Neisseria. Risk factor – SARS.

Pathomorphology. Intense inflammation, desquamation of the subpharyngeal epithelium and abundant purulent-mucous secretion that disrupts the functions of the respiratory tract and makes it difficult to carry out therapeutic measures to restore these functions.

Clinical picture

    • Barking rough cough
    • Voice changes are traditionally absent
    • Increase in body temperature >38 °C
    • Intoxication syndrome
    • Edema of the lower parts of the larynx
    • Rapidly developing stridor
    • Child

traditionally occupies a supine position

    • Absence of salivation and dysphagia (important for differential diagnosis with inflammation of the upper larynx)
    • No response to aerosol treatment using adrenaline (unlike those with croup).

Laboratory research

    • Leukocytosis with a shift of the leukocyte formula to the left
    • Bacteriological examination of blood is traditionally uninformative
    • Bacterioscopy and bacteriological examination of tracheal secretion. Special Studies
    • X-ray studies
    • X-ray of the neck in a lateral projection – narrowing in the lower parts of the larynx and trachea with blurred X-ray formations (strings)
    • Infiltrates can be found in the lungs
    • Endoscopic examination: pronounced inflammation of the lower parts of the larynx and trachea with abundant purulent-mucous secretion and desquamated epithelium, separated from the walls of the trachea by layers. Differential Diagnosis
    • Laryngotracheomalacia
    • Epiglottitis
    • foreign body
    • Retropharyngeal abscess
    • Pneumonia
    • false croup
    • diphtheria laryngitis.


Tactics of conducting

    • Frequent small meals and plenty of fluids. Perhaps the appointment of diet number 13
    • Infusion therapy
    • Warm humid air in the room
    • Endotracheal or nasotracheal intubation (usually for 3-13 days). Drug therapy
    • Antibacterial therapy
    • Oxacillin sodium salt 0.25-0.5 g 4-6 r / day for adults, 1 g / day for children from 3 months to 2 years in 4-6 doses, 2 g / day for children from 2 to 6 years in 4- 6
    • tricks.
    • Cefotaxime 1 g intravenously and 12 hours later for adults and children over 12 years old, 50-100 mg/kg/day in 2-4 doses (up to 2 g/day) for children under 12 years of age.
    • Cefuroxime 0.75 g 3-4 r / day i.v., 75 mg / kg / day in 4 divided doses for children.
    • In case of allergy to penicillins and cephalosporins – clindamycin 40 mg/kg/day in 4 divided doses or chloramphenicol (levomycetin) 75 mg/kg/day in 4 divided doses.
    • When coughing, the appointment of expectorants or antitussives is indicated. Joint appointments should be avoided.
    • Expectorants – see bacterial pneumonia.
    • Antitussives – according to indications (for example, with an unproductive or severe nocturnal cough)
    • Glaucine hydrochloride 50 mg 2-3 r / day after meals for adults, 10-30 mg for children. Due to the likely hypotensive effect, the product should not be prescribed for arterial hypotension or myocardial infarction
    • Broncholitin 1 tbsp. 3-4 r / day for adults, 1 tsp. 3 r / day for children over 3 years old, 2 tsp. 3 r / day for children over 10 years old
    • Libeksin 100 mg 3-4 r / day for adults, 25-50 mg 3-4 r / day for children. To avoid anesthesia of the oral mucosa, the product is recommended to be swallowed without chewing.
    • Tusuprex (oxeladine citrate) 10-20 mg 3-4 r / day for adults, 5-10 mg 3-4 r / day for children.


    • Post-intubation stenosis of the lower larynx
    • Pneumonia
    • Toxic shock syndrome, traditionally due to the production of enterotoxin by staphylococci.

Course and forecast

    • Full recovery after correction of airway patency and during intubation up to 13 days
    • Lethal outcome – against the background of cardiac and respiratory arrest. See also Bronchiolitis, Diphtheria, Laryngitis ICD
    • J04.1 Acute tracheitis
    • J04.2 Acute laryngotracheitis

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