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Bacterial Tracheitis, Emergency Medicine

Noah K. Rosenberg and Gary Bubly Reviewed 06/2017
 


Basics

Description

  • A tracheal infection potentially causing acute airway obstruction. Also known as bacterial croup and laryngotracheobronchitis. Exudative tracheitis can refer to a less severe form of...

Diagnosis

Signs and Symptoms

History

Usually preceding viral infection with acute deterioration in course of illness 

Physical Exam

  • Fever

  • Cough

  • Retractions

  • Inspiratory/expiratory stridor

  • Toxic appearance

  • Hoars...

Treatment

Pre-Hospital

  • Assess airway/breathing:

    • Supplemental oxygen

    • Racemic epinephrine aerosol if easily tolerated

    • Reassurance; avoid agitating child

  • Bag-valve-mask (BVM) ventilation if in respiratory fai...

Follow-Up

Disposition

Admission Criteria

All patients with suspected or documented bacterial tracheitis: 
  • Admit to PICU.

  • PICU length of stay varies from 3–9 days.

Discharge Criteria

None 

Issues for Referral

...

Pearls and Pitfalls

  • Consider in patients with croup-like illness who rapidly deteriorate.

  • May be more severe in younger patients due to narrower tracheal diameters.

Additional Reading

  • Hopkins  BS, Johnson  KE, Ksiazek  JM, et al. H1N1 influenza presenting as bacterial tracheitis. Otolaryngol Head Neck Surg.  2010;142:612–614.

  • Hopkins  A, Lahiri  T, Salerno  R...

Codes

ICD9

  • 464.4 Croup

  • 464.11 Acute tracheitis with obstruction

  • 464.21 Acute laryngotracheitis with obstruction

ICD10

  • J04.11 Acute tracheitis with obstruction

  • J05.0 Acute obstructive laryngitis [croup]

SNOMED

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