Traqueítis bacteriana: una causa infecciosa de obstrucción de la vía aérea que hay que considerar en la infancia

Alonso, S Marcos; Menchón, N. Molini; Núñez, Antonio Rodríguez; Torres, Federico Martinón; Sánchez, J.M.a Martinón

doi:10.1157/13077460

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…The classic description of a child with BT is a patient with a toxic appearance, stridor, tachypnea, voice changes or hoarseness, fever, and dysphagia that rapidly deteriorates within a period of two to 10 hours [ 1 , 2 , 6 , 7 ] Many patients present prodromal symptoms, such as low-grade fever, cough, and rhinorrhea. This clinical evolution supports the hypothesis that BT is a bacterial infection superimposed over a viral upper respiratory tract infection [ 1 , 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Over the past years, several studies have been reporting a shift in BT epidemiology and presentation, with patients presenting milder symptoms and no signs of systemic infection, such as high fever or toxic appearance [ 1 - 3 ]. Therefore, BT should be suspected in cases of stridor and respiratory distress, with poor or absent response to systemic corticosteroids or nebulized epinephrine [ 7 ]. The presence of purulent secretions, tracheal inflammation, and subglottic narrowing with a normal epiglottis on direct larynx observation confirms the diagnosis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Bacterial Tracheitis: A New Presentation of a Well-Known Disease

Moreira,

Ferreira,

Sarmento

et al. 2024

Cureus

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Bacterial tracheitis (BT) is an uncommon life-threatening condition that results in acute upper airway obstruction. Classical signs include a toxic appearance, stridor, tachypnoea, and fever, often leading to rapid clinical deterioration. Recent studies have shown a shift in BT epidemiology and presentation, where stridor and respiratory distress are now predominant. A poor response to corticosteroids or nebulized epinephrine is also commonly described, along with a need for mechanical ventilation. We present the case of a five-year-old boy admitted to the emergency department with cough, stridor, and dyspnea that had significantly worsened over the previous hours. He presented reasonable general condition, marked retractions, poor air entry, stridor, and wheezing. Investigation revealed a slight elevation of C-reactive protein and leukocytosis with neutrophilia. Anteroposterior x-ray showed narrowing of subglottic airways (steeple sign). There was no response to oral/nebulized corticoids, nebulized adrenaline, or bag-valve-mask oxygenation. Antibiotic therapy with ceftriaxone was initiated. Due to deteriorating clinical conditions with severe respiratory acidosis, orotracheal intubation was required. Later Streptococcus pyogenes was isolated in the bronchial secretions and a targeted antibiotic regimen was administered. Progressive clinical and analytical improvement was observed with no complications. Although uncommon, BT remains a severe infectious condition affecting otherwise healthy children. Our case underscores the severity of the disease and the imperative for invasive interventions to achieve favorable outcomes. It also supports recent findings indicating a shift in predominant symptoms and prognosis. Clinicians must be vigilant and knowledgeable, recognizing that worsening stridor and respiratory distress unresponsive to conservative treatment are key indicators for diagnosing BT.

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