Tracheitis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD

Tracheitis is caused by inflammation of the trachea. Initial presentation is characterized by cough, fever, shortness of breath and hoarseness of voice. Thick exudates develop in the trachea which increase tracheal obstruction and can cause severe respiratory distress. Common complications of tracheitis include hypotension, acute renal failure, septic shock, acute respiratory distress syndrome, toxic shock syndrome and pulmonary edema. ^[1]

• The symptoms of tracheitis usually develop in the first and second decade of life, and start with symptoms such as cough, change in voice quality and difficulty in breathing.
• The symptoms of tracheitis typically develop after exposure to viruses e.g parainfluenza, rhinovirus, metapneumovirus, adenovirus. After the prodromal viral illness develops, superimposed bacterial infection can occur and cause even more severe disease.
• Mild upper respiratory tract symptoms predominate in the initial 3-7 days. As the secondary bacterial infection develops the symptoms worsen with marked respiratory distress and stridor. In some individuals, sudden deterioration can occur within 24-48 hours of initial presentation requiring airway intubation. ^[2]

Common complications of tracheitis include: ^[3]

• Airway obstruction — can lead to death
• Toxic shock syndrome — caused by the bacteria Staphylococcus Aureus
• Acute Respiratory Distress Syndrome
• Septic Shock^[4]
• Pulmonary Edema^[5]
• Acute Renal Failure
• Pneumonia^[6]
• Pneumothorax
• Pneumomediastinum
• Lobar atelectasis

With prompt treatment, the child should recover. Presentations and severity are less so in adults. ^[7]

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