Advertisement

Tracheobronchitis in the ICU

  • Dan Schuller
  • Subramanian Paranjothi
Chapter
  • 345 Downloads

Abstract

Tracheobronchitis can be broadly denned as an inflammatory process of the airways between the larynx and the bronchioles. Clinically, this is a syndrome recognized by an increase in the volume and purulence of the lower respiratory tract secretions frequently associated with signs of variable airflow obstruction. In the intensive care unit (ICU), tracheobronchitis is a relatively common problem related to multiple potential insults to the airway of a critically ill host. For instance, the presence of an endotracheal tube, the frequent suctioning needed to maintain airway clearance, the process of bacterial colonization and the aspiration of contaminated secretions are only a few of the multiple triggers of an inflammatory response in the airway.

Keywords

Respiratory Syncytial Virus Lower Respiratory Tract Invasive Pulmonary Aspergillosis Bronchiolitis Obliterans Tracheal Stenosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Siegal MD, Tocino I. Chest radiology in the intensive care unit. Clin Pulmonary Med 6:347, 1999.CrossRefGoogle Scholar
  2. 2.
    Santos E, Talusan A, Brandestetter RD. Radiographic mimics of pneumonia in the critical care unit. Crit Care Clin 14:91, 1998.PubMedCrossRefGoogle Scholar
  3. 3.
    Niederman MS, Craven DE, Fein AM, et al. Respiratory infection complication long-term tracheostomy: the implication of persistent Gram-negative tracheobronchial colonization. Chest 85:39, 1984.PubMedCrossRefGoogle Scholar
  4. 4.
    Johanson WG, Pierce AK, Sanford JP, et al. Nosocomial respiratory infections with gram-negative bacilli. Ann Intern Med 77:701, 1972.PubMedCrossRefGoogle Scholar
  5. 5.
    Örtqvest Å, Hammers-Berggren S, Kalin M. Respiratory tract colonization and incidence of secondary infection during hospital treatment of community-acquired pneumonia. Eur J Clin Microbiol Infect Dis 9:725, 1990.CrossRefGoogle Scholar
  6. 6.
    Salata RA, Ellner JJ. Bacterial colonizaton of the tracheobronchial tree. Clin Chest Med 91:623, 1988.Google Scholar
  7. 7.
    Harlid R, Andersson G, Frostell CG, et al. Respiratory tract colonization and infection in patients with chronic tracheostomy: a one-year study in patients living at home. Am J Respir Crit Care Med 154:124, 1996.PubMedCrossRefGoogle Scholar
  8. 8.
    Rogers RM, Weiler C, Ruppenthal B. Impact of the respiratory intensive care unit on survival of patients with acute respiratory failure. Chest 62:94, 1972.PubMedCrossRefGoogle Scholar
  9. 9.
    Cross AS, Roup B. Role of respiratory assistance devices in endemic nosocomial pneumonia. Am J Med 70:681, 1981.PubMedCrossRefGoogle Scholar
  10. 10.
    Niederman MS, Ferranti RD, Zeigler A, et al. Respiratory infection complicating long-term tracheostomy. Chest 85:39, 1984.PubMedCrossRefGoogle Scholar
  11. 11.
    Bartlett JT, Faling LJ, Willey S. Quantitative tracheal bacteriological and cytologic studies in patients with long-term tracheostomies. Chest 74:635, 1978.PubMedCrossRefGoogle Scholar
  12. 12.
    Levine SA, Niederman MS. The impact of tracheal intubation on host defenses and risks for nosocomial pneumonia. Clin Chest Med 12:523, 1991.PubMedGoogle Scholar
  13. 13.
    Gal TJ. How does tracheal intubation alter respiratory mechanics? Probl Anesth 2:191, 1988.Google Scholar
  14. 14.
    Klainer AS, Turndorf H, Wu WH, et al. Surface alterations due to endotracheal intubation. Am J Med 58:674, 1975.PubMedCrossRefGoogle Scholar
  15. 15.
    Ramphal R, Guay P. Pseudomonas aeruginosa adhesions for tracheobronchial mucin. Infect Immun 55:600, 1987.PubMedGoogle Scholar
  16. 16.
    Ramphal R, Pyle M. Adherence of mucoid and nonmucoid Pseudomonas aeruginosa to acid-injured tracheal epithelium. Infect Immun 41:345, 1983.PubMedGoogle Scholar
  17. 17.
    Craven DE, Goularte TA, Make BJ. Contaminated condensate in mechanical ventilator circuits: a risk factor for nosocomial pneumonia. Am Rev Respir Dis 129:625, 1984.PubMedGoogle Scholar
  18. 18.
    Craven DE, Lichtenberg DA, Goularte TA, et al. Contaminated medication nebulizers in mechanical ventilator circuits: source of bacterial aerosols. Am J Med 77:834, 1984.PubMedCrossRefGoogle Scholar
  19. 19.
    Schwartz SN, Dowling JN, Benkovic C, et al. Sources of gram-negative bacilli colonizing the trachea of intubated patients. J Infect Dis 138: 227, 1978.PubMedCrossRefGoogle Scholar
  20. 20.
    Niederman MS, Mantovani R, Schoch P, et al. Patterns and routes of tracheobronchial colonization in mechanically ventilated patients: the role of nutritional status in colonization of the lower airway by Pseudomonas species. Chest 95:155, 1989.PubMedCrossRefGoogle Scholar
  21. 21.
    Johanson WG Jr, Pierce AK, Sanford JP, et al. Nosocomial respiratory infections with gram-negative bacilli: the significance of colonization of the respiratory tract. Ann Intern Med 77:701, 1972.PubMedCrossRefGoogle Scholar
  22. 22.
    Niederman MS, Ferranti RD, Ziegler A, et al. Respiratory infection complicating long-term tracheostomy: The implication of persistent gram-negative tracheobronchial colonization. Chest 85:39, 1984.PubMedCrossRefGoogle Scholar
  23. 23.
    George DL, Falk PS, Wunderink RG, et al. Epidemiology of ventilator-acquired pneumonia based on protected bronchoscopic sampling. Am J Respir Crit Care Med 158:1839, 1998.PubMedCrossRefGoogle Scholar
  24. 24.
    Namba Y, Mihara N, Tanaka M. Fulminant tracheobronchitis caused by methicillin-resistant Staphylococcus aureus (MRSA) (Japanese). Nihon Kyobu Shikkan Gakkai Zasshi. Jap J Thoracic Dis 35:969, 1997.Google Scholar
  25. 25.
    Cefai C, Richads J, Gould FK, et al. An outbreak of Acinetobacter respiratory tract infection resulting from incomplete disinfection of ventilatory equipment. J Hosp Infect 15:177, 1990.PubMedCrossRefGoogle Scholar
  26. 26.
    Seifert H, Strate A, Pulverer G. Nosocomial bacteremia due to Acinetobacter baumanniii: Clinical features, epidemiology, and predictors of mortality. Medicine 74:340, 1995.PubMedCrossRefGoogle Scholar
  27. 27.
    Seifert H, Baginski R, Schulze A, et al. Antimicrobial susceptibility of Acinetobacter species. Antimicrob Agents Chemother 37:750, 1993.PubMedCrossRefGoogle Scholar
  28. 28.
    Chen YC, Chang SC, Hsieh WC, et al. Acinetobacter calcoaceticus bacteremia: analysis of 48 cases. J Formosan Med Assoc 90:958, 1991.PubMedGoogle Scholar
  29. 29.
    Leigh MW, Clyde WA. Chlamydial and mycoplasmal pneumonias. Semin Respir Infect 2:152, 1987.PubMedGoogle Scholar
  30. 30.
    Glezen WP, Loda FA, Clyde WA, et al. Epidemiologic patterns of acute lower respiratory disease of children in a pediatric practice. J Pediatr 78:397, 1971.PubMedCrossRefGoogle Scholar
  31. 31.
    Rose RM, Pinkston P, O’Donnell C, et al. Viral infection of the lower respiratory tract. Clin Chest Med 8:405, 1987.PubMedGoogle Scholar
  32. 32.
    Fischman RA, Marschall KE, Kislak JW, et al. Adult respiratory distress syndrome caused by Mycoplasma pneumonia. Chest 74:471, 1978.PubMedCrossRefGoogle Scholar
  33. 33.
    Zack MB, Kazemi H. Carbon dioxide retention in Mycoplasma pneumonia. Am Rev Respir Dis 107:1052, 1973.PubMedGoogle Scholar
  34. 34.
    Clarke A, Skelton J, Fraser RS. Fungal tracheobronchitis: report of 9 cases and review of the literature. Medicine 70:1, 1991.PubMedCrossRefGoogle Scholar
  35. 35.
    Meyer RD, Young LS, Armstrong D, et al. Aspergillosis complicating neoplastic disease. Am J Med 54:6, 1973.PubMedCrossRefGoogle Scholar
  36. 36.
    Orr DP, Myerowitz RL, Dubois PJ. Pathoradiologic correlation of invasive pulmonary aspergillosis in the compromised host. Cancer 41:2028, 1978.PubMedCrossRefGoogle Scholar
  37. 37.
    Young RC, Bennett JE, Vogel CL, et al. Aspergillosis. The spectrum of the disease of 98 patients. Medicine 49:149, 1970.CrossRefGoogle Scholar
  38. 38.
    Dubois PJ, Myerowitz RL, Allen CM. Pathoradiologic correlation of pulmonary candidiasis in immunosuppressed patients. Cancer 40:1026, 1977.PubMedCrossRefGoogle Scholar
  39. 39.
    Chakravarty SC. Bronchopulmonary candidiasis: Clinical aspects. Dis Chest 51:608, 1967.CrossRefGoogle Scholar
  40. 40.
    Wengrower D, Or R, Segal E, Kleinman Y Bronchopulmonary candidiasis exacerbating asthma. Case report and a review of the literature. Respiration 42:209, 1985.CrossRefGoogle Scholar
  41. 41.
    Kramer MR, Denning DW, Marshall SE, et al. Ulcerative tracheobronchitis after lung transplantation: a new form of invasive aspergillosis. Am Rev Respir Dis 144:552, 1991.PubMedCrossRefGoogle Scholar
  42. 42.
    Gerson SL, Talbot GH, Hurwitz S, et al. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med 100:345, 1984.PubMedCrossRefGoogle Scholar
  43. 43.
    Lehrer RI, Cline MJ. Leukocyte candidacidal activity and resistance to systemic candidiasis in patients with cancer. Cancer 27:1211, 1971.PubMedCrossRefGoogle Scholar
  44. 44.
    Dale DC, Petersdorf RG. Corticosteroids and infectious diseases. Med Clin North Am 57:1277, 1973.PubMedGoogle Scholar
  45. 45.
    Bodey GP. Candidiasis in cancer patients. Am J Med 77(Suppl4D):13, 1984.PubMedGoogle Scholar
  46. 46.
    Denny FW Jr. The clinical impact of human respiratory virus infections. Am J Respir Crit Care Med 152:S4, 1995.PubMedCrossRefGoogle Scholar
  47. 47.
    Ellenbogen C, Graybill JL, Silva J, et al. Bacterial pneumonia complicating viral pneumonia. Am J Med 56:169, 1974.PubMedCrossRefGoogle Scholar
  48. 48.
    Frank AL, Taber LH, Wells CR, et al. Patterns of shedding of myxoviruses and paramyxoviruses in children. J Infect Dis 144:433, 1981.PubMedCrossRefGoogle Scholar
  49. 49.
    Davies KJ, Herbert AM, Westmoreland D, et al. Seroepidemiological study of respiratory virus infections among dental surgeons. Br Dent J 176:262, 1994.PubMedCrossRefGoogle Scholar
  50. 50.
    Kark JD, Lebiush M, Rannon L. Cigarette smoking as a risk factor for epidemic A(H1N1) influenza in young men. N Engl J Med 307: 1042, 1982.PubMedCrossRefGoogle Scholar
  51. 51.
    Mullooly JP, Barker WH, Nolan TF Jr. Risk of acute respiratory disease among pregnant women during influenza A epidemics. Public Health Rep 101:205, 1986.PubMedGoogle Scholar
  52. 52.
    Conway SP, Simmonds EJ, Littlewood JM. Acute severe deterioration in cystic fibrosis associated with influenza A virus infection. Thorax 47:112, 1992.PubMedCrossRefGoogle Scholar
  53. 53.
    O’Brien TG, Sweeney DF. Interstitial viral pneumonitis complicated by severe respiratory failure: successful management using intensive dehydration and steroids. Chest 63:314, 1973.PubMedCrossRefGoogle Scholar
  54. 54.
    Roberts GBS. Fulminating influenza. Lancet 2:944, 1957.CrossRefGoogle Scholar
  55. 55.
    Winther B, Brofeldt S, Gronborg H, et al. Study of bacteria in the nasal cavity and nasopharynx during naturally acquired common cold. Acta Otolaryngol 98:315, 1984.PubMedCrossRefGoogle Scholar
  56. 56.
    The Medical Letter, Inc. Rapid diagnostic tests for influenza 41:121, 1999.Google Scholar
  57. 57.
    Calfee DP, Hayden FG. New approaches to influenza chemotherapy. Neuraminidase inhibitors. Drugs 56:537, 1998.PubMedCrossRefGoogle Scholar
  58. 58.
    Smith CB, Kanner RE, Golden CA, et al. Effect of viral infection on pulmonary function in patients with chronic obstructive pulmonary diseases. J Infect Dis 141:271, 1980.PubMedCrossRefGoogle Scholar
  59. 59.
    Bateman ED, Hayashi S, Kuwano K, et al. Latent adenoviral infection in follicular bronchiectasis. Am J Respir Crit Care Med 151:170, 1995.PubMedCrossRefGoogle Scholar
  60. 60.
    Morales F, Calder MA, Inglis JM, et al. A study of respiratory infections in the elderly to assess the role of respiratory syncytial virus. J Infect 7:236, 1983.PubMedCrossRefGoogle Scholar
  61. 61.
    Zaroukian MH, Kashyap GH, Wentworth BB. Case report: respiratory syncytial virus infection: a case of respiratory distress syndrome and pneumonia in adults. Am J Med Sci 295:218, 1988.PubMedCrossRefGoogle Scholar
  62. 62.
    Englund JA, Piedra PA, Jewell A, Patel K, Baxter BB, Whimbey E. Rapid diagnosis of respiratory syncytial virus infection in immunocompromised adults. J Clin Microbiol 34:1649, 1996.PubMedGoogle Scholar
  63. 63.
    Morgan HR, Finland M. Isolation of herpes virus from a case of atypical pneumonia and erythema multiforme exudativum: with studies of four additional cases. Am J Med Sci 217:92, 1949.PubMedCrossRefGoogle Scholar
  64. 64.
    Stern H, Elek SD, Millar DM, Anderson HE Herpetic whitlow: a form of cross-infection in hospitals. Lancet 2:871, 1959.PubMedCrossRefGoogle Scholar
  65. 65.
    Lheureux P, Verhest A, Vincent JL, Liénard C, Levivier M, Kahn RJ. Herpes virus infection, an unusual source of adult respiratory distress syndrome. Aur J Respir Dis 67:72, 1985.Google Scholar
  66. 66.
    Benjamin DR. Herpes simplex tracheobronchitis and pneumonitis. Pediatr Pathol 9:773, 1989.PubMedCrossRefGoogle Scholar
  67. 67.
    Nash G, Foley FD. Herpetic infection of the middle and lower respiratory tract. Am J Clin Pathol 54:857, 1970.PubMedGoogle Scholar
  68. 68.
    Ramsey PG, Fife KH, Hackman RC, Mayers JD, Corey L. Herpes simplex virus pneumonia: clinical, virologic, and pathologic features in 20 patients. Ann Intern Med 97:813, 1982.PubMedCrossRefGoogle Scholar
  69. 69.
    Frable WJ, Frable MA, Seney FD Jr. Virus infections of the respiratory tract: cytopathologic and clinical analysis. Acta Cytol 21:32, 1977.PubMedGoogle Scholar
  70. 70.
    Tuxen DV, Wilson JW, Cade JF. Prevention of lower respiratory herpes simplex virus infection with acyclovir in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 136:402, 1987.PubMedCrossRefGoogle Scholar
  71. 71.
    Tuxen DV, Cade JF, McDonald MI, Buchanan MR, Clark RJ, Pain MC. Herpes simplex virus from the lower respiratory tract in adult respiratory distress syndrome. Am Rev Respir Dis 126:416, 1982.PubMedGoogle Scholar
  72. 72.
    Prellner T, Flamholc L, Haidl S, Lindholm K, Widell A. Herpes simplex virus — the most frequently isolated pathogen in the lungs of patients with severe respiratory distress. Scand J Infect Dis 24:283, 1992.PubMedCrossRefGoogle Scholar
  73. 73.
    Sherry MK, Klainer AS, Wolff M, Gerhard H. Herpetic tracheobronchitis. Ann Intern Med 109:229, 1988.PubMedCrossRefGoogle Scholar
  74. 74.
    Legge RH, Thompson AB, Linder J, Woods GL, Robbins RA, Moulton AL, et al. Acyclovir-responsive herpetic tracheobronchitis. Am J Med 85:516, 1988.CrossRefGoogle Scholar
  75. 75.
    Chakraborty A, Forker A, Reese H, Casey J. Tracheobronchitis and pneumonia due to herpes simplex virus (HSV) infection. Nebr Med J 73:347, 1988.PubMedGoogle Scholar
  76. 76.
    Vaxelaire JF, Brunet F, Armaganidis A, Pochard F, Giraud T, Lanore JJ, et al. The role of herpes simplex virus in respiratory complications after cardiac surgery (abstract). Am Rev Respir Dis 143:A474, 1991.Google Scholar
  77. 77.
    Porteous C, Bradley JA, Hamilton DN, Ledingham IM, Clements GB, Robinson CG. Herpes simplex virus reactivation in surgical patients. Crit Care Med 12:626, 1984.PubMedCrossRefGoogle Scholar
  78. 78.
    Avery RK, Longworth DL. Viral pulmonary infections in thoracic and cardiovascular surgery. Sem Thoracic Cardiovasc Surg 7:88, 1995.Google Scholar
  79. 79.
    Cook CH, Yenchar JK, Kraner TO, Davis EA, Ferguson RM. Occult herpes family viruses may increase mortality in critically ill surgical patients. Am J Surg 176:357, 1988.CrossRefGoogle Scholar
  80. 80.
    St. John RC, Pacht ER. Tracheal stenosis and failure to wean from mechanical ventilation due to herpetic tracheitis. Chest 98:1520, 1990.PubMedCrossRefGoogle Scholar
  81. 81.
    Corey L, Spear PG. Infections with herpes simplex viruses. N Engl J Med 314:749, 1986.PubMedCrossRefGoogle Scholar
  82. 82.
    Nash G. Necrotizing tracheobronchitis and bronchopneumonia consistent with herpetic infection. Hum Pathol 3:283, 1972.PubMedCrossRefGoogle Scholar
  83. 83.
    Graham BS, Snell JD Jr. Herpes simplex virus infection of the adult lower respiratory tract. Medicine 62:384, 1983.PubMedCrossRefGoogle Scholar
  84. 84.
    Herout V, Vortel V, Vondrackova A. Herpes simplex involvement of the lower respiratory tract. Am J Clin Pathol 46:411, 1966.PubMedGoogle Scholar
  85. 85.
    Schuller D, Spessert C, Fraser JV, Goodenberger DM. Herpes simplex virus from respiratory tract secretions: epidemiology, clinical characteristics, and outcome in immunocompromised and non-immunocompromised hosts. Am J Med 94:29, 1993.PubMedCrossRefGoogle Scholar
  86. 86.
    Perl TM, Haugen TH, Pfaller MA, Hollis R, Lakeman AD, Whitley RJ, et al. Transmission of herpes simplex virus type 1 infection in an intensive care unit. Ann Intern Med 117:584, 1992.PubMedCrossRefGoogle Scholar
  87. 87.
    Papazian L, Fraisse L, et al. Cytomegalovirus. An unexpected cause of ventilator-associated pneumonia. Anesthesiology 84:280, 1996.PubMedCrossRefGoogle Scholar
  88. 88.
    Domart Y, Trouillet JL, Fagan JY, Chastre J, Brun-Vezinet F, Gilbert C. Incidence and morbidity of cytomegaloviral infection in patients with mediastinitis following cardiac surgery. Chest 97:18, 1990.PubMedCrossRefGoogle Scholar
  89. 89.
    Cushing D, et al. Herpes simplex virus and cytomegalovirus excretion associated with increased ventilator days in trauma patients. J Trauma 35:161, 1993.Google Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Dan Schuller
  • Subramanian Paranjothi

There are no affiliations available

Personalised recommendations