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Query: UMLS:C0040584 (tracheitis)
 384 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serious bacterial infections occurred in ten children (1.4%) of 710 patients with croup admitted to the Soroka Medical Center during the years 1983-1989. Sixty-four patients (9% of all croup patients) were admitted to the pediatric intensive care unit (PICU), and 13 of them (20%) required intubation. Bacterial infections were noted in nine of the 13 intubated patients, in none of the other 51 PICU patients who did not require intubation and in one of the 646 patients (0.2%) who were not admitted to the PICU (p less than 0.0001). There was no difference in age, ethnic origin, or body temperature on arrival between the two PICU groups. Causative microorganisms were isolated from blood samples (three cases) and tracheal pus (eight cases). All intubated PICU patients were seriously ill: eight had bacterial tracheitis and one supraglottitis. Patients with bacterial tracheitis required frequent suctioning of the trachea for copious purulent secretions. The single patient with bacterial infection who was not admitted to the PICU had transient bacteremia. We conclude that the need for intubation in croup patients was an indicator for the presence of a serious bacterial infection.
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PMID:The need for intubation in serious upper respiratory tract infection in pediatric patients (a retrospective study). 188 64

Twenty-five pediatric orthotopic liver transplantations (OLTs) performed in 22 patients at Sainte-Justine Hospital were reviewed for infections complications. One patient died within 12 hours posttransplantation and is excluded. The patients had an average age of 6.1 years (range, 1.25 to 19 years) and an average weight of 20.4 kg (range, 11 to 55 kg). Two patients (9%) were cytomegalovirus (CMV) seropositive and 9 of 19 patients (48%) were Epstein-Barr virus (EBV) seropositive preoperatively. Five of the donors (20%) were CMV seropositive. The most common indications for OLT were biliary atresia (8) and tyrosinemia (7). There were 4 deaths, for an overall mortality rate of 19%. In 3 patients, deaths were related to infection (CMV hepatitis and duodenitis with aortoduodenal fistula, adult respiratory distress syndrome [ARDS] with Streptococcus viridans pneumonia, Escherichia coli cholangitis with progressive hepatic failure). Fifteen patients (72%) had 41 major infections, most of them bacterial, during the first month posttransplantation. These include pneumonia (25%), line sepsis (17%), cholangitis (14%), and tracheitis (14%). There was only one major viral infection, a CMV hepatitis that occurred in the first month posttransplantation. Three patients had fungal infections (8%) associated with hepatic artery thrombosis and recurrent cholangitis. All three patients required retransplantation. There was only one protozoal infection (Pneumocystis carinii pneumonia) causing life-threatening respiratory failure, from which patient recovered without sequelae. Infection still remains a serious complication of OLT. Bacterial infection is common and is usually associated with technical complications. The low rate of CMV infection is related to low incidence of CMV in the donor pool and the minimal use of strong immunosuppressants.
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PMID:Infectious complications of pediatric liver transplantation. 191 82

Between October 1989 and August 1990, Dallas County experienced an 11-month epidemic of measles. Of 995 cases of pediatric measles diagnosed in the outpatient department of Children's Medical Center, 108 patients were admitted and 34 of these demonstrated significant upper airway obstruction at the time of admission. Airway problems ranged from mild inspiratory stridor with nasal flaring to frank obstruction and arrest in the emergency room, requiring intubation. Eight of the 34 airway patients were eventually diagnosed with bacterial tracheitis on the basis of endoscopic findings and culture results. The remaining patients had pictures more consistent with viral laryngotracheitis, but all patients were treated with broad-spectrum antibiotics to prevent possible progression to bacterial tracheitis. A total of nine patients overall required intubation for airway obstruction and all were successfully extubated. Large outbreaks of measles are becoming common again in populations of urban poor--largely unvaccinated children. The disease in these populations tends to occur at a younger age and may be more aggressive with more associated complications. Physicians must keep in mind the possibility of upper airway obstruction in a significant proportion of these patients. Early diagnosis on the basis of clinical signs and symptoms, endoscopy, and radiographs is the key to timely appropriate management.
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PMID:Measles: an epidemic of upper airway obstruction. 194 28

To assess whether there is any advantage in the use of corticosteroid to prevent postextubation stridor in children, we conducted a prospective, randomized, double-blind trial of dexamethasone versus saline solution. The patients were evaluated and then randomly selected to receive either dexamethasone or saline solution according to a stratification based on risk factors for postextubation stridor: age, duration of intubation, upper airway trauma, circulatory compromise, and tracheitis. Dexamethasone, 0.5 mg/kg, was given every 6 hours for a total of six doses beginning 6 to 12 hours before and continuing after endotracheal extubation in a pediatric intensive care setting. There was no statistical difference in incidence of postextubation stridor in the two groups; 23 of 77 children in the placebo group and 16 of 76 in the dexamethasone group had stridor requiring therapy (p = 0.21). We conclude that the routine use of corticosteroids for the prevention of postextubation stridor during uncomplicated pediatric intensive care airway management is unwarranted.
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PMID:Dexamethasone in the prevention of postextubation stridor in children. 199 63

The occasional pathogenicity of nondiphtheria corynebacteria in both immunocompetent and immunocompromised individuals is now well established. Previously described sites of infection include heart valves, wounds, urinary tract, and lungs. This report of necrotizing tracheitis caused by Corynebacterium pseudodiphtheriticum illustrates the widening spectrum of infections caused by these organisms. A 54-year-old man developed respiratory distress and symptoms of upper airway obstruction unresponsive to inhaled bronchodilators, systemic corticosteroids, or intravenous erythromycin. A spirometry flow-volume loop demonstrated fixed upper airway obstruction. Fiberoptic bronchoscopic examination revealed a circumferential inflammatory process partially occluding the tracheal lumen. Gram staining revealed gram-positive rods typical of corynebacteria, and cultures of tracheal tissue yielded C. pseudodiphtheriticum resistant to erythromycin and clindamycin. There was no clinical or laboratory evidence for exotoxin or cell-associated toxins. Treatment with intravenous penicillin resulted in resolution of the inflammatory process and eradication of the organisms, as assessed by subsequent cultures.
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PMID:Necrotizing tracheitis caused by Corynebacterium pseudodiphtheriticum: unique case and review. 201 36

Bacterial tracheitis is an uncommon cause of acute respiratory distress in children. The authors present a case of bacterial tracheitis in a 6-year-old girl caused by an unusual pathogen, Streptococcus pneumoniae. Her clinical presentation and radiographic findings are typical for an older child. Management of this case involved endotracheal intubation, although a review of the literature suggests that airway management can vary with age and size of the tracheal lumen. The microbiology of bacterial tracheitis shows a predominance of Staphylococcus and Streptococcus reported previously, with only three prior reported cases of Pneumococcus.
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PMID:Pneumococcal bacterial tracheitis. 201 95

Groups of female New Zealand White rabbits, 8-10 weeks old, were inoculated intranasally with three different Pasteurella multocida serotypes (A:3, A:4 and A:12) or one of three Bordetella bronchiseptica strains of rabbit origin. Seven out of 18 rabbits died of experimental infection with P. multocida. B. bronchiseptica killed 3 out of the 8 animals inoculated with it. Deaths occurred between 3 and 6 days postinoculation (PI). In the rabbits that died of P. multocida inoculation, necropsy and histology revealed severe pleuritis with the accumulation of a remarkable amount of fibrinopurulent exudate in the thoracic cavity, serous rhinitis and tracheitis, acute hepatitis with necrotic foci in the parenchyma, and atrophy of the lymphoid organs and tissues. Rabbits killed 10 days PI developed only subacute serous rhinitis and hyperplasia of the lymphoid tissues. Rabbits that died of B. bronchiseptica inoculation showed acute serous rhinitis, acute catarrhal-fibrinopurulent pneumonia and mild pleuritis. As opposed to P. multocida inoculated animals, hepatitis and atrophy of the lymphoid tissues were not characteristic of these rabbits. Rabbits killed 10 days PI developed subacute purulent and necrotic pneumonia with remarkable macrophage proliferation, involving all lobes, and hyperplasia of the lymphoid tissues.
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PMID:The pathology of experimental respiratory infection with Pasteurella multocida and Bordetella bronchiseptica in rabbits. 209 6

For many years Branhamella catarrhalis was regarded as a non-pathogenic inhabitant of the respiratory tract. This article outlines the spectrum of B. catarrhalis disease in childhood and the extent of the evidence for a pathogenic role of the organism. B. catarrhalis is a rare etiologic agent in septicemia, meningitis, and other systemic illness in both apparently normal and immunocompromised infants and children. It is an unusual cause of ophthalmia neonatorum, but can be confused with Neisseria gonorrhoeae. Whether or not B. catarrhalis is acquired from the birth canal in these cases has not been established. B. catarrhalis is most common as a respiratory tract pathogen in children, including pneumonia, bacterial tracheitis, sinusitis, and otitis media. Since it is difficult to rigorously document pathogenicity of any bacterium in bronchopulmonary infections in children, it is probable that the spectrum of B. catarrhalis disease is wider than that reported to date. The evidence for pathogenicity in acute otitis media is more extensive than for other infections. Otitis media due to B. catarrhalis is clinically similar to that due to other pathogens. B. catarrhalis can be isolated in pure culture from the middle ear exudate and persists if there is no antibacterial treatment. Gram-negative intracellular and extracellular diplococci can be seen on smears of the inflammatory exudate. There is preliminary evidence that there is an antibody response in B. catarrhalis otitis media. B. catarrhalis has emerged as an important and common pathogen in neonates, infants, and children.
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PMID:Spectrum of disease due to Branhamella catarrhalis in children with particular reference to acute otitis media. 211 Oct 87

A transtracheal catheter (TTC) (Scoop) was implanted in 24 patients (19 men, 5 women) with a mean age of 64 +/- 9 (47 to 78) years. The pO2 was 6.78 +/- 1.65 kPa. Two patients suffered from pulmonary restriction, 22 from severe COPD with a FEV1 of 880 +/- 165 ml. Purulent tracheitis developed in six patients. The pre-Scoop catheter had to be removed in three. In four patients, bronchoscopic aspiration of mucus plugs adhering to the tip of the TTC was necessary. In one patient, the TTC was removed after an uneventful course due to patient's discomfort; another patient no longer qualified for LOT. 19 patients were using the TTC without major problems. Of those, five have died due to severe lung disease. By using TTC, oxygen consumption is halved for the same degree of oxygenation. 12 are using a demand valve device (Oxymatic), which allows a further conservation of oxygen. Patients prefer LOT by a TCC for cosmetic reasons and lack of nasal discomfort.
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PMID:[Experiences with long-term transtracheal oxygen therapy]. 211 84

Bobwhite quails (Colinus virginianus) were inoculated with 10(6) mean tissue-culture infective dose of quail bronchitis virus at 1, 3, 6, or 9 weeks of age by intratracheal, intraperitoneal, or subcutaneous routes. Quails developed necrotizing tracheitis, proliferative and necrotizing bronchitis and pneumonia; multifocal necrotizing hepatitis; necrotizing splenitis, with or without hyperplasia of splenic mononuclear phagocytes; bursal lymphoid necrosis; and bursal atrophy. Lesions were more extensive and severe in quails inoculated at 1 or 3 weeks of age than in older quails. Large intranuclear inclusions, characteristic of adenovirus infection, were identified in trachea, lung, liver, and bursa of Fabricius. This is the first report of the histopathology of experimentally induced quail bronchitis.
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PMID:Pathology of experimentally induced quail bronchitis. 215 96


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