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Tracheitis is a topic covered in the Select 5-Minute Pediatrics Topics.

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Infection of the trachea associated with airway inflammation and obstruction

  • Acute tracheitis: sudden onset; higher morbidity and mortality
  • Subacute tracheitis: indolent presentation and course; more common among children with prolonged intubation, tracheostomy, and/or underlying respiratory or neurologic conditions


  • Viral prodrome common
  • Increased incidence during viral respiratory season (fall and winter): up to 75% coinfected with influenza A
  • Gender predisposition unclear (2:1 male-to-female ratio has been reported)
  • 3% mortality rate

General Prevention

  • Routine childhood immunization with Haemophilus influenzae type b, influenza, measles, and pneumococcal vaccines
  • Avoid overaggressive suctioning of children with artificial airways.


  • Epithelial damage from a viral infection or mechanical trauma (e.g., endotracheal intubation, surgical procedure) occurs in the trachea at the level of the cricoid cartilage. As a result, the damaged tissue is more susceptible to bacterial superinfection.
  • Mucosal damage characterized by marked subglottic edema, copious purulent secretions, and a pseudomembrane (mucosal lining, inflammatory products, and bacteria). These changes lead to marked airway obstruction.
  • Toxic shock syndrome may be a consequence if the infection is associated with toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes.


  • Bacteria
    • Staphylococcus aureus (most common), group A β-hemolytic Streptococcus, Moraxella catarrhalis, nontypeable H. influenzae, Streptococcus pneumoniae
    • Pseudomonas aeruginosa and other gram-negative enteric bacteria have been associated with nosocomial infections.
    • Mycobacterium tuberculosis, Mycoplasma pneumoniae, Corynebacterium diphtheriae, H. influenzae type b, and respiratory anaerobic bacteria are uncommon pathogens.
  • Viruses: Influenza, parainfluenza, respiratory syncytial, herpes simplex, and measles viruses have been found with bacterial pathogen(s).
  • Fungi: seen with underlying immunodeficiency disorders or chronic steroid use

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Cabana, Michael D., editor. "Tracheitis." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. 5minute, www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14189/all/Tracheitis.
Tracheitis. In: Cabana MD, ed. Select 5-Minute Pediatrics Topics. 7th ed. Wolters Kluwer Health; 2015. https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14189/all/Tracheitis. Accessed June 17, 2019.
Tracheitis. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics. Available from https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14189/all/Tracheitis
Tracheitis [Internet]. In: Cabana MD, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2019 June 17]. Available from: https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14189/all/Tracheitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Tracheitis ID - 14189 ED - Cabana,Michael D, BT - Select 5-Minute Pediatrics Topics UR - https://www.unboundmedicine.com/5minute/view/Select-5-Minute-Pediatric-Consult/14189/all/Tracheitis PB - Wolters Kluwer Health ET - 7 DB - 5minute DP - Unbound Medicine ER -