Bacterial Tracheitis Workup

Updated: Nov 26, 2018
  • Author: Sujatha Rajan, MD; Chief Editor: Russell W Steele, MD  more...
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Workup

Laboratory Studies

Obtain bacterial culture and Gram stain of tracheal secretions and blood cultures in patients with suspected bacterial tracheitis.

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Imaging Studies

Radiography of the neck may be indicated.

  • Neither definitive nor essential

  • Portable, not in the radiology suite, only in the stable patient

  • May reveal subglottic narrowing on anteroposterior (AP) views - Steeple sign, similar to croup (See the image below.)

    Steeple sign. Steeple sign.
  • May reveal clouding of tracheal air column or irregular tracheal margin on lateral view

  • Concretions of epithelium and inflammatory cells possibly mimicking a foreign body

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Procedures

Laryngotracheobronchoscopy is indicated.

  • Only definitive means of diagnosis

  • Direct visualization and culture of purulent tracheal secretions

  • May be therapeutic by performing tracheal toilet and stripping purulent membranes

  • Pediatric-sized bronchoscopes and experts at pediatric airway management not available at all facilities

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