Tracheitis

Bacterial tracheitis is a rare infectious cause of acute upper airway blockage, except in individuals with a tracheostomy or endotracheal tube. It is now more common in children who have received the Haemophilus type B immunization than acute epiglottitis. Even though patients with bacterial tracheitis may present with croup-like symptoms like barking cough, stridor, and fever, they do not respond to standard croup therapy (racemic epinephrine) and instead need antibiotic treatment and may experience acute respiratory decompensation. Bacterial tracheitis is characterized by mucopurulent membranes that adhere or partially adhere to the tracheal mucosa and a generalized inflammatory response, including the larynx, trachea, and bronchi. Illness is most prevalent at the level of the cricoid cartilage, the narrowest section of the trachea. Subglottic edema and epithelial sloughing or mucopurulent membrane buildup within the trachea can lead to acute airway blockage. Symptoms are often milder than epiglottitis but more severe than croup. Controlling the airway is the first order of business in children, exhibiting symptoms of severe airway blockage or impending respiratory failure (such as significant retractions, inadequate air entry, weariness, listlessness, or decreased awareness). Due to their smaller airway width, children under 2–3 years old may be at a higher risk of developing a life-threatening illness.