RT Book, Section
A1 Shah, Ashish
A1 Sobolewski, Brad
A1 Mittiga, Matthew R.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181044597
T1 Membranous (Bacterial) Tracheitis
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181044597
RD 2024/04/24
AB Membranous  tracheitis  is  an  acute  exudative  bacterial  infection  (S  aureus,  H  influenzae,  M  catarrhalis,  streptococci,  and  pneumococci)  of  the  upper  airway  capable  of  causing  life-threatening  airway  obstruction.  It  may  present  as  a  primary  infection  or  occur  as  a  secondary  bacterial  complication  of  a  viral  infection  of  the  upper  respiratory  tract.  This  locally  invasive  infection  of  the  tracheal  mucosa  below  the  vocal  cords  produces  copious  purulent  secretions.  The  exudate  can  form  a  thick  plug  that  may  ultimately  lead  to  an  acute  tracheal  obstruction.  Patients  appear  toxic,  with  high  fever  and  a  croup-like  syndrome  that  can  progress  rapidly.  The  characteristic  “membranes”  may  be  seen  on  x-rays  of  the  airway  as  edema  with  an  irregular  border  of  the  subglottic  tracheal  mucosa.  On  direct  laryngoscopy,  profuse  purulent  secretions  can  be  found  in  the  presence  of  a  normal  epiglottis.  The  differential  diagnosis  includes  acute  laryngotracheobronchitis,  RPA,  epiglottitis,  peritonsillar  abscess,  foreign-body  aspiration,  and  acute  diphtheric  laryngitis.