Occurring almost exclusively in children, bacterial tracheitis is a rare but rapidly life-threatening upper airway disease with reported mortality rates as high as 20%. Clinicians must recognize this disease promptly to prevent impending airway obstruction and its associated complications, which include acute respiratory distress syndrome and septic shock. Approximately 80% of patients with bacterial tracheitis require intubation, and 94% are admitted to the intensive care unit. Bacterial tracheitis affects 2 groups of pediatric patients: those with a native, intact airway and those with an artificial airway established with an endotracheal tube or tracheotomy tube.

Bacterial tracheitis without tracheotomy is also known as membranous laryngotracheobronchitis, bacterial laryngotracheobronchitis, and pseudomembranous croup. As implied by these alternative names, the hallmark findings of bacterial tracheitis are ulceration and pseudo membrane formation in the trachea, mucopurulent exudate, and sloughing of the mucosa, which obstruct the tracheal lumen and can lead to significant airway obstruction. Historically,...

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