Bacterial Tracheitis Workup

Updated: Nov 01, 2023
  • Author: Sujatha Rajan, MD; Chief Editor: Russell W Steele, MD  more...
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Laboratory and Imaging Studies

Laboratory studies

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

Imaging studies

Radiography of the neck may be indicated. Note the following:

  • 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



Laryngotracheobronchoscopy is indicated. Note the following:

  • 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