Bacterial tracheitis--an old disease rediscovered.

During a 3-year period, seven children with bacterial tracheitis were admitted to the intensive care unit of the Winnipeg Children's Hospital. The illness was characterized by fever, toxicity, and stridor. Respiratory difficulty was secondary to copious thick purulent tracheal secretions. In the majority of patients the illness was caused by Staphylococcus aureus, and the rest had Hemophilus influenzae infection. Viral studies in five patients were negative. Most patients required endotracheal intubation and frequent tracheal toilet to prevent serious airway obstruction. In our ICU, bacterial tracheitis accounted for about 14 per cent of admissions with infectious upper airway obstructive illness, while epiglottis and croup accounted for 55 per cent and 31 per cent, respectively. Only 5 per cent of children with croup admitted to the hospital were admitted to the ICU. Bacterial tracheitis has reappeared, at least in North America, as an important and serious cause of obstructive upper airway disease in children and must be recognized early in order to prevent catastrophic airway obstruction.