Further Outpatient Care

Patient should complete an appropriate course (usually 10 d) of oral antibiotics.

Further Inpatient Care

Consider extubation when bacterial tracheitis appears to be resolving, especially with decreased secretions suctioned from the endotracheal tube.

Transfer

Transfer is required for patients in respiratory distress, patients in need of a pediatric intensive care unit, and patients who need a pediatric-sized bronchoscope.

Complications

The following complications have been reported:

Pneumonia - Reported in 19-60% of cases (Guidelines for avoiding health care–associated pneumonia have been established.^[14])
Septicemia
Toxic shock
Adult respiratory distress syndrome (ARDS)
Endotracheal tube complications
- Plugging, accidental extubation
- Postextubation stridor, subglottic stenosis
Anoxic encephalopathy
Cardiorespiratory arrest

A retrospective study by Gross et al, in which four patients who received antibiotic treatment for bacterial laryngotracheitis showed improvement in presumed iatrogenic laryngotracheal stenosis, suggested that airway bacterial growth is significantly involved in adult postintubation airway injury. The patients had a history of intubation and/or tracheostomy, with complete resolution of upper airway obstruction seen in three of the patients after laryngotracheitis treatment and significant improvement of airway status seen in the fourth.^[15]

Prognosis

Once the patient is past the acute phase, complete recovery is expected.

Patient Education

Keep immunizations up-to-date.

Questions

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Dawood FS, Chaves SS, Pérez A, Reingold A, Meek J, Farley MM, et al. Complications and associated bacterial coinfections among children hospitalized with seasonal or pandemic influenza, United States, 2003-2010. J Infect Dis. 2014 Mar 1. 209(5):686-94. [QxMD MEDLINE Link].
Tebruegge M, Pantazidou A, Thorburn K, et al. Bacterial tracheitis: a multi-centre perspective. Scand J Infect Dis. 2009 Apr 28. 1-10. [QxMD MEDLINE Link].
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[Guideline] Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R. Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004 Mar 26. 53:1-36. [QxMD MEDLINE Link].
Gross JH, Giraldez-Rodriguez LA, Klein AM. Bacterial Laryngotracheitis and Associated Upper Airway Obstruction: A Case Series. Ann Otol Rhinol Laryngol. 2015 Dec. 124 (12):1002-5. [QxMD MEDLINE Link].
Bernstein T, Brilli R, Jacobs B. Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit. Clin Infect Dis. 1998 Sep. 27(3):458-62. [QxMD MEDLINE Link].
Brook I. Aerobic and anaerobic microbiology of bacterial tracheitis in children. Pediatr Emerg Care. 1997 Feb. 13(1):16-8. [QxMD MEDLINE Link].
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Casazza G, Graham ME, Nelson D, Chaulk D, Sandweiss D, Meier J. Pediatric Bacterial Tracheitis-A Variable Entity: Case Series with Literature Review. Otolaryngol Head Neck Surg. 2018 Oct 23. 194599818808774. [QxMD MEDLINE Link].

Media Gallery

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Author

Sujatha Rajan, MD Assistant Professor of Pediatrics, Albert Einstein School of Medicine; Consulting Staff, Department of Pediatrics, Division of Pediatric Infectious Diseases, Schneider Children's Hospital, North Shore-Long Island Jewish Health System

Sujatha Rajan, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Coauthor(s)

Kathryn Clark Emery, MD Associate Professor, Department of Pediatrics, University of Colorado Health Sciences Center; Consulting Staff, Department of Emergency Medicine, Children's Hospital of Denver

Kathryn Clark Emery, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Sunil K Sood, MBBS, , MD Professor of Clinical Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine; Chief, Pediatric Infectious Diseases, Firm Director, Pediatric Unit, Schneider Children's Hospital at North Shore, North Shore University Hospital

Sunil K Sood, MBBS, , MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Joseph Domachowske, MD Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University

Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa

Disclosure: Received research grant from: Pfizer;GlaxoSmithKline;AstraZeneca;Merck;American Academy of Pediatrics, Novavax, Regeneron, Diassess, Actelion<br/>Received income in an amount equal to or greater than $250 from: Sanofi Pasteur.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.