BACTERIAL TRACHEITIS

Question 1

Etiology

Answer 1

Staph Aureus
Strep Pneumoniae
H Flu
Moraxella

Question 2

DDx

Answer 2

Anaphylaxis
Angioedema

Foreign body
Croup
Epiglotittis
Retropharyngeal / Peritonsilar abscess
Bacterial Tracheitis

Question 3

Investigations

Answer 3

Lateral neck and chest XRAY: subglottic narrowing of trachea with irregular densities and ragged and indistinct borders

Bronchoscopy most diagnostic

Question 4

Management

Answer 4

Monitor
Oxygen
Vitals
IV Access
Equipment: Airway
Have bagmask ready

Alert ENT or anesthestiology for emergent airway management

Airway management and bronchoscopy in the operating room

Racemic Epi (2.25%), 0.05 mL / kg / dose up to 0.5 mL
OR
L-epinoephrine (1:1000) 0.5 ml / kg / dose up to 5 mL

Dexamethasone 0.6 mg / kg IV
OR
Methylprednisone 2 mg / kg IV

Ampicillin / Sulbactam 50 mg / kg IV
OR
Cefuroxime 50 mg / kg IV
AND
Clindamycin 10 mg / kg IV
+/-
Vancomycin 10 mg / kg IV