Airway endoscopy in the diagnosis and treatment of bacterial tracheitis in children

Hans Edmund Eckel, Brigitte Widemann, Michael Damm, Bernd Roth

Research output: Contribution to journalArticle

Abstract

Children with bacterial tracheitis present with the symptoms of viral laryngotracheobronchitis or epiglottitis, but do not respond to appropriate therapy for these diseases and frequently develop acute respiratory decompensation. Since the treatment and outcome of bacterial tracheitis differ so much from those of viral laryngotracheobronchitis and epiglottitis, prompt and accurate diagnosis is essential. The aim of this study was to evaluate the significance of different diagnostic characteristics in a group of eleven patients and to compare the results to those recently reported in the pediatric and otorhinolaryngologic literature. The present study suggests that reliable predictive factors do not exist for bacterial tracheitis. No single clinical, radiological or laboratory feature was a reliable diagnostic predictor for bacterial tracheitis, nor was it any combination of these features. The only diagnostic procedure to distinguish bacterial tracheitis accurately and promptly from other forms of acute obstructive upper airway diseases was direct laryngotracheo-bronchoscopy. Following endoscopic removal of all tracheal secretions and pulmonary toilet, nasotracheal intubation provides sufficient airway maintenance and obviates the need for tracheostomy. Endoscopy is thus diagnostic and therapeutic at the same time. If bacterial tracheitis is suspected a direct laryngoscopy and rigid tracheobronchoscopy should be performed under general anesthesia, as prompt diagnosis and adequate treatment are essential to survival. The cultures of the purulent tracheal secretions frequently revealed Staphylococcus aureus in combination with various pathogens, particularly the involvement of Pseudomonas aeruginosa was noted in two patients. Our data imply a susceptibility of children with Down's syndrome or immunodeficiency to bacterial tracheitis.

Original languageEnglish (US)
Pages (from-to)147-157
Number of pages11
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume27
Issue number2
DOIs
StatePublished - 1993
Externally publishedYes

Fingerprint

Tracheitis
Endoscopy
Epiglottitis
Therapeutics
Laryngoscopy
Tracheostomy
Bronchoscopy
Down Syndrome
Intubation
General Anesthesia
Pseudomonas aeruginosa
Staphylococcus aureus
Maintenance
Pediatrics
Lung
Survival

Keywords

  • Bacterial tracheitis
  • Children
  • Croup
  • Down's syndrome
  • Endoscopy
  • Epiglottitis
  • Pseudomonas aeruginosa
  • Tracheoscopy

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Airway endoscopy in the diagnosis and treatment of bacterial tracheitis in children. / Eckel, Hans Edmund; Widemann, Brigitte; Damm, Michael; Roth, Bernd.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 27, No. 2, 1993, p. 147-157.

Research output: Contribution to journalArticle

Eckel, Hans Edmund ; Widemann, Brigitte ; Damm, Michael ; Roth, Bernd. / Airway endoscopy in the diagnosis and treatment of bacterial tracheitis in children. In: International Journal of Pediatric Otorhinolaryngology. 1993 ; Vol. 27, No. 2. pp. 147-157.
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