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

Autor:	Moreira M; Pediatrics and Child Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, PRT., Ferreira PR; Pediatric Intensive Care Unit, Centro Materno Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT., Sarmento A; Pediatric Intensive Care Unit, Centro Materno Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, PRT., Cardoso AL; Pediatric Intensive Care Unit, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, PRT.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 02; Vol. 16 (7), pp. e63697. Date of Electronic Publication: 2024 Jul 02 (Print Publication: 2024).
DOI:	10.7759/cureus.63697
Abstrakt:	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. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Moreira et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu