Donnelly B W, McMillan J A, Weiner L B
Department of Pediatrics, SUNY Health Science Center, Syracuse 13210.
Rev Infect Dis. 1990 Sep-Oct;12(5):729-35. doi: 10.1093/clinids/164.5.729.
Bacterial tracheitis, previously referred to as nondiphtheritic laryngitis with marked exudate, was commonly discussed in pediatric textbooks before 1940. It seemed to disappear as a clinical entity after that time, but it has been recorded with increasing frequency in the pediatric literature since 1979. We describe eight new cases and review 110 previously described cases. The clinical course consists of a prodromal upper respiratory illness with stridor, fever, and a variable degree of respiratory distress. Unlike patients with croup, patients with bacterial tracheitis do not respond to aerosolized racemic epinephrine. Most patients require endotracheal intubation; some require tracheostomy. Reported complications include pneumonia, pneumothorax, formation of pseudomembranes, toxic shock syndrome, and cardiopulmonary arrest. Bacterial tracheitis is a secondary bacterial infection following a primary viral respiratory infection. The most common preceding viral infection is parainfluenza. Staphylococcus aureus and Haemophilus influenzae are the predominant causes of bacterial tracheitis. Secondary bacterial infection may occur as a result of tracheal mucosal injury or impairment of normal phagocytic function due to viral infection.
细菌性气管支气管炎，以前称为伴有明显渗出物的非白喉性喉炎，在1940年以前的儿科教科书中经常被讨论。在那之后，它似乎作为一种临床实体消失了，但自1979年以来，它在儿科文献中的记录频率越来越高。我们描述了8例新病例，并回顾了110例先前描述的病例。临床病程包括前驱性上呼吸道疾病，伴有喘鸣、发热和不同程度的呼吸窘迫。与患哮吼的患者不同，细菌性气管支气管炎患者对雾化消旋肾上腺素无反应。大多数患者需要气管插管；一些患者需要气管切开术。报道的并发症包括肺炎、气胸、假膜形成、中毒性休克综合征和心肺骤停。细菌性气管支气管炎是原发性病毒性呼吸道感染后的继发性细菌感染。最常见的前驱病毒感染是副流感。金黄色葡萄球菌和流感嗜血杆菌是细菌性气管支气管炎的主要病因。继发性细菌感染可能是由于气管黏膜损伤或病毒感染导致正常吞噬功能受损所致。
