Bacterial tracheitis in children: Treatment and prevention
- Charles R Woods, MD, MS
Charles R Woods, MD, MS
- Professor of Pediatrics
- University of Louisville School of Medicine
- Section Editors
- Glenn C Isaacson, MD, FAAP
Glenn C Isaacson, MD, FAAP
- Section Editor — Pediatric Otolaryngology
- Professor, Departments of Otolaryngology, Head and Neck Surgery and Pediatrics
- Lewis Katz School of Medicine at Temple University
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
The treatment and prevention of bacterial tracheitis in children will be reviewed here. The clinical features and diagnosis of bacterial tracheitis and tracheal infections associated with tracheostomy tubes and endotracheal intubation in children are discussed separately. (See "Bacterial tracheitis in children: Clinical features and diagnosis" 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 . Other terms that have been used to describe this condition include "bacterial croup," "membranous croup," "pseudomembranous croup," "acute laryngotracheobronchitis," and "membranous laryngotracheobronchitis" . (See "Bacterial tracheitis in children: Clinical features and diagnosis", section on 'Terminology'.)
OVERVIEW OF TREATMENT
The cornerstones of treatment for bacterial tracheitis are maintenance of the airway, fluid resuscitation (if needed), and administration of appropriate antimicrobial agents. Some children require emergent or urgent evaluation of the airway via endoscopy. This procedure generally is best performed in the operating room, intensive care unit, or equivalent setting . (See "Bacterial tracheitis in children: Clinical features and diagnosis", section on 'Endoscopy' and "Emergency evaluation of acute upper airway obstruction in children".)
Children with bacterial tracheitis generally should be admitted to a pediatric intensive care unit even if endotracheal intubation is not required, so they can be monitored for potential disease progression.
Overview — Maintenance of the airway is the mainstay of treatment of bacterial tracheitis. Initial airway management is based upon the degree of respiratory distress as determined by clinical assessment. In children with signs of severe airway obstruction or impending respiratory failure (ie, hypoxia, marked retractions, poor air entry, fatigue, listlessness, or depressed level of consciousness) airway control precedes diagnostic evaluation.
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- OVERVIEW OF TREATMENT
- AIRWAY MANAGEMENT
- Supplemental oxygen
- Artificial airway
- FLUID MANAGEMENT
- ANTIMICROBIAL THERAPY
- Antibacterial therapy
- - Duration
- Antiviral therapy
- CLINICAL COURSE
- OUTCOMES AND COMPLICATIONS
- SUMMARY AND RECOMMENDATIONS