The trachea (windpipe) is an important part of the body’s airway system. When air enters through the nose or mouth, it travels through the larynx (an organ that aids in breathing and sound production, also called the voice box), and down the windpipe. The trachea then branches into two tubes, called bronchi, which deliver air directly to the lungs. In addition to delivering oxygen to the lungs, the trachea also carries carbon dioxide out of the body through exhalation.
Tracheitis is a bacterial infection of the trachea. According to Medscape Reference (MR), this type of infection typically affects younger children, but children up to the age of 16 may also be at risk. Bacterial tracheitis is more common in boys; however, it is a rare disease, affecting 0.1 per 100,000 children per year. (MR, 2010)
Although bacterial tracheitis is rare, if not treated promptly it can lead to life-threatening complications.
Bacterial tracheitis is typically caused by Staphylococcus aureus. However, there are other bacteria that can cause these infections. These include:
- Streptococcus pneumonia
- Haemophilus influenza
- Moraxella catarrhalis
Although cases of the disorder have been reported in adults, bacterial tracheitis is most commonly seen in young children. Bacterial tracheitis often develops following an upper respiratory infection (URI), such as the common cold. Following a URI, bacteria are able to more easily invade the trachea, causing infection, inflammation, and rapid swelling.
Because the trachea of children is small and because of the position of the trachea in children, even mild swelling may quickly block the airway. This condition may not occur as rapidly in adults, and the infection may heal before the airway becomes obstructed. This may explain why bacterial tracheitis is seen more commonly in children than in adults.
Since cases of bacterial tracheitis often follow an upper respiratory infection, initial symptoms such as cough, runny nose, or a low-grade fever may appear. After two to five days, symptoms of infection and airway obstruction may develop. These symptoms may include:
- deep, severe cough
- difficulty breathing
- high fever
- high-pitched sound when breathing (stridor)
- nasal flaring
- cyanosis, a blue color of the skin associated with lack of oxygen
A high-pitched sound while breathing can be a sign of serious infection and represents partial airway obstruction, a potentially fatal condition. If you or your child develops any of these symptoms, seek medical attention immediately.
Your doctor will be able to diagnose bacterial tracheitis with a physical exam and by listening to your lungs for signs of respiratory distress. To confirm diagnosis and rule out other health problems, your doctor may order additional tests. These may include:
- blood oxygen level
- nasopharyngeal culture – taking a sample of mucous secretions from the uppermost part of the throat to see if bacteria are present
- tracheal culture to see if bacteria are present
- X-ray of the trachea
Treatment will focus on clearing the airway and curing the infection. Most people with this condition will need a device called an endotracheal tube inserted into the airway to help with breathing. Once the tube is placed in your airway (intubation), it is connected to a ventilator. Intubation will improve lung function while you recover from your infection.
While you are intubated, you will receive antibiotics to fight the infection. These medications will be given to you through a vein in your arm (intravenously).
The outlook for this condition depends on how quickly you seek treatment. Airways in small children can swell quickly, making it difficult for them to breathe. If the trachea becomes completely blocked, this can lead to respiratory arrest and death.
If your infection is caused by the S. aureus bacterium you may also be at risk for developing toxic shock syndrome, which can lead to fever, shock, and organ failure. This condition can be fatal. However, with prompt treatment you are expected to make a full recovery.