Bacterial Tracheitis

Abstract

In 1979 Jones, Santos, and Overall described eight children with an acute, infectious, upper airway obstructive disease that they termed “bacterial tracheitis” (16). Direct laryngoscopic examination revealed a normal epiglottis but marked subglottic edema and copious purulent secretions in the subglottic area. Cultures of these secretions grew bacterial pathogens. Since that description, numerous case reports describing a similar syndrome in children have appeared in the literature.* This chapter is devoted to a discussion of this entity. To provide a historical perspective, literature published in the first half of the century describing acute infectious upper airway obstruction in children is reviewed. Such reports suggest that bacterial tracheitis is an old disease that has been rediscovered. The discussion then focuses on the pathogenesis of bacterial tracheitis, with specific emphasis on the anatomy of the upper respiratory tract and on evidence that a viral infection may provide a “fertile soil for bacterial invasion” (25). Next follows a comprehensive review of all the cases of bacterial tracheitis reported in the English literature since 1979. This serves to highlight the clinical and laboratory findings associated with the syndrome. Finally, specific therapeutic measures are discussed, with the objective of eliminating morbidity and mortality associated with this disease.