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Bacterial tracheitis in children: Clinical features and diagnosis

Charles R Woods, MD, MS
Section Editors
Glenn C Isaacson, MD, FAAP
Sheldon L Kaplan, MD
Deputy Editor
Carrie Armsby, MD, MPH


The clinical features and diagnosis of bacterial tracheitis in children will be reviewed here. The treatment of bacterial tracheitis and tracheal infections associated with tracheostomy tubes and endotracheal intubation in children are discussed separately. (See "Bacterial tracheitis in children: Treatment and prevention" and "Tracheobronchitis associated with tracheostomy tubes and endotracheal intubation in children".)


Bacterial tracheitis is an invasive exudative bacterial infection of the soft tissues of the trachea (picture 1) [1]. In some cases, there is involvement of the subglottic laryngeal structures, extension into the upper bronchial tree, or associated pneumonia [2-5]. Thus, "acute bacterial laryngotracheobronchitis" may be a more accurate clinical and anatomic description of this entity, but "bacterial tracheitis" is the preferred terminology in most textbooks and publications. (See 'Pathogenesis and pathology' below.)

Other terms that have been used to describe invasive exudative bacterial infection of soft tissues of the trachea include "bacterial croup," "membranous croup," "pseudomembranous croup," "acute laryngotracheobronchitis," and "membranous laryngotracheobronchitis" [6].


The larynx of healthy individuals is often colonized with bacterial species common to the upper respiratory tract, some of which are potential pathogens (eg, Staphylococcus aureus, Streptococcus pneumoniae, gram-negative enteric bacteria, Pseudomonas aeruginosa). Such colonization can extend, at least transiently, into the trachea [7]. Bacterial colonization of the trachea may be present within 24 hours after birth, even in infants born at <31 weeks gestation [8].

Bacterial tracheitis almost always occurs in the setting of prior airway mucosal damage, as occurs with antecedent viral infection [9,10] (see 'Predisposing viruses' below). Aspiration of bacteria-laden secretions into the trachea during bacterial infection of the upper respiratory tract (eg, acute bacterial sinusitis, streptococcal pharyngitis) or after tonsillectomy also may lead to bacterial tracheitis [9,11].

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Literature review current through: Dec 2017. | This topic last updated: Jul 27, 2017.
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