Bacterial Tracheitis: Pathogenesis and Clinical Findings
Authors: Fasika Jembere Reviewers: Simran Sandhu Mao Ding Danielle Nelson * MD at time of publication
Recent upper respiratory viral infection
Age typically <6 years old (more common in males) Children at higher risk due physiologic narrowing of airway Recent upper respiratory viral infection (often in Fall/Winter; respiratory virus season) Damage to airway mucosa Activation of systemic inflammatory response Inflammatory cytokines release into systemic circulation ↑ Thermo-regulatory set- point at the hypothalamus ↑ Work of breathing to adequately ventilate lungs Respiratory distress (nasal flaring, grunting) Activation of local inflammatory response Results in thick mucopurulent secretions, ulcerations, and shedding of tracheal mucosa Mucopurulent discharge secretion of fluid contains mucus and pus ↑ Production of mucous results in more accumulation Predisposition to bacterial infection Bacterial pathogen invades trachea Ex: S. aureus (common), S. pyogenes, M. catarrhalis, or H. influenzae Often high fever Trachea is narrowed with purulent debris Upper airway obstruction causes turbulent airstreams Hoarse voice Tachypnea Stridor (with inhalation & exhalation; may be biphasic) Tracheal tenderness ↓ Mucous clearance from the airways Excess airway mucous triggers cough reflex Cough (may be barky) ↑ Use of accessory respiratory muscles (sternocleidomastoid and scalene muscles) Toxic appearance (lethargy, cyanosis) ↓ Level of consciousness (due to hypoxia & hypercarbia) Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Jan 11, 2024 on www.thecalgaryguide.com