Tracheitis recognizes several causes. In most cases, it is the consequence of an "infection: bacteria are the main culprits (in particular Staphylococcus aureus and it Streptococcus pneumoniae); however, viruses also play a significant role.
A classic tracheitis due to infectious agents produces: cough, runny nose, fever, retrosternal pain, emission of abnormal sounds during breathing (stridor and rales) and difficulty in breathing.
If the inflammation is particularly severe, the trachea can become completely occluded and the patient risks respiratory arrest.
An accurate diagnosis and the identification of the triggering causes allows to plan the most adequate treatment.
When the tracheitis is very severe, the patient needs immediate therapy and hospitalization.
, the trachea is the respiratory tract that connects the larynx to the bronchi.
On average 12 centimeters long, the trachea contributes to the transit of inhaled and exhaled air.
Epidemiology of Tracheitis
Anyone can develop tracheitis, especially the infectious forms; tracheal inflammation, however, is more common in particular categories of people, such as children, smokers and those who are exposed almost daily to respiratory tract irritants.
Primary Tracheitis and Secondary Tracheitis
Before analyzing the responsible agents, it should be noted that tracheitis of an infectious nature is distinguished into primary and secondary: primary tracheitis derives from a "direct infection of the trachea, while secondary tracheitis from a" infection originating in a tract of the upper airways and extending to the trachea only at a later time.
Bacterial Tracheitis
As the name suggests, bacterial tracheitis is inflammation of the trachea due to the action of a bacterium.
Among the bacteria that most commonly cause tracheitis are:
- Staphylococcus aureus. It is the bacterial agent at the origin of most cases of tracheitis.
Generally, it colonizes the skin, cutaneous glands and the upper respiratory tract, and is the cause of boils and abscesses; less frequently, it affects the internal organs and is responsible for gastroenteritis, osteomyelitis, septic arthritis, pneumonia, meningitis, endocarditis, septicemia and the so-called toxic shock syndrome.
Tracheitis induced by Staphylococcus aureus it can be primary or secondary; when it is secondary it derives from an "infection affecting the nasopharyngeal tract (therefore rhinitis, pharyngitis or laryngitis). - MRSA. It is a particular strain of Staphylococcus aureus, resistant to the antibiotic methicillin (MRSA, in fact, is the acronym for Staphylococcus Aureus Methicillin Resistant).
Consequentially, MRSA is very similar to normal Staphylococcus aureus: it mainly causes abscesses and boils, but, occasionally, it can also cause endocarditis, pneumonia, septic arthritis, osteomyelitis and septicemia.
Tracheitis due to MRSA can be primary or secondary. - Streptococcus pneumoniae. It is the main bacterial agent that causes pneumonia in adults.
In reality, however, this microorganism can also have other consequences, some mild and others decidedly more severe.
Among the mild conditions, bronchitis, conjunctivitis, otitis media, sinusitis and tracheitis are included; among the serious conditions, however, septic arthritis, bacteremia, infectious cellulitis deserve a particular mention. , meningitis, osteomyelitis, pericarditis and peritonitis.
Tracheitis from Streptococcus pneumoniae it can be primary or secondary; if it is secondary, it usually results from sinusitis. - Haemophilus influenzae. It is the class of bacteria that predominantly colonize the upper and lower upper airways.
Generally, Haemophilus influenzae it is responsible for sinusitis, otitis media and bronchitis; more rarely, it causes pneumonia and meningitis.
Tracheitis due to Haemophilus influenzae it is often the result of sinusitis, so it is secondary. - Moraxella catarrhalis. It is a typical colonizer of the upper and lower first airways.
Usually, Moraxella catarrhalis causes the appearance of sinusitis, laryngitis, bronchitis and otitis media; only in rare cases, does it induce the appearance of more serious conditions, such as pneumonia, urethritis, septic arthritis and septicemia.
Tracheitis caused by Moraxella catarrhalis is generally secondary, resulting from episodes of sinusitis or laryngitis. - Klebsiella pneumoniae. It is a bacterial agent that, in most cases, infects the upper airways and urinary tract, and only in rare cases causes meningitis, osteomyelitis, pneumonia and bacteremia.
Tracheitis due to Klebsiella pneumoniae it is mostly secondary.
Viral Tracheitis
As can be understood, viral tracheitis is the inflammation of the trachea following the action of a virus.
Viruses potentially capable of causing tracheitis include:
- Influenza viruses. Remember that there are three types of influenza viruses: type A, type B and type C.
- Cold viruses. Viruses that cause colds are numerous; the main ones are Rhinoviruses (between 30 and 80% of cases), followed by Coronaviruses, Adenoviruses, respiratory syncytial virus, Enteroviruses, etc.
- Parainfluenza viruses. They are the viruses responsible for the so-called parainfluenza syndrome.
Generally, the inflammation of the trachea caused by the aforementioned viral agents is secondary, as it results from some form of rhinitis, pharyngitis or laryngitis.
Non-Infectious Tracheitis
Non-infectious tracheitis can be due to:
- The involuntary inhalation of objects, which, stopping in the trachea, cause it to become inflamed.
- Smoking. Cigarette smoke is an "irritant to the entire respiratory tract;" moreover, it is a contributing factor to respiratory infections.
Generally, smoking-related tracheal inflammations are chronic. - Environmental, domestic or work pollution. If the inhaled air contains pollutants or irritating substances for the respiratory mucosa, it can cause inflammation of the airways it passes through (in particular, it is harmful to the trachea and the bronchial tree).
Environmental, domestic or work pollution is more associated with chronic inflammation of the respiratory tract. - The inhalation of pollen, dust, animal hair and similar substances. These are allergens that can cause tracheitis in subjects with a hypersensitivity or a real allergy.
Acute Tracheitis and Chronic Tracheitis
Tracheitis can be an acute or chronic condition.
Acute tracheitis is inflammation of the trachea with a sudden and abrupt onset, intense in terms of symptoms and of relatively short duration.
Chronic tracheitis, on the other hand, is inflammation of the trachea with gradual onset, mild in terms of symptoms, long lasting and subject to recurrent relapses.
Generally, acute tracheitis has an infectious origin, while chronic tracheitis is due to non-infectious causes.
Tracheitis: Risk Factors
Factors such as:
- Direct or indirect contact with people with a "respiratory tract infection caused by one of the infectious agents listed above (eg: Streptococcus pneumoniae, Staphylococcus aureus etc.);
- The presence of a state of immunosuppression (due, for example, to AIDS, the use of immunosuppressive drugs or diabetes);
- Living in highly polluted cities;
- The practice of jobs in which airways irritants are breathed daily;
- To smoke.
Through a narrower trachea, the air passes with greater difficulty.
Generally, cough, runny nose and fever are characteristic of the onset phase of tracheitis; while respiratory abnormalities (stridor, breathlessness, etc.) and retrosternal pain characterize the later stage of inflammation, usually appearing 2 -5 days after the first manifestations.
Symptoms related to conditions such as rhinitis, pharyngitis or laryngitis (i.e. sore throat, nasal congestion, sneezing, etc.) may present before the trachea becomes inflamed or arise together with the later manifestations of tracheitis.
For further information: Tracheitis SymptomsNon-Infectious Tracheitis: Symptoms
With the exception of fever and a few other symptoms, non-infectious tracheitis manifests itself in a very similar way to infectious tracheitis.
Tracheitis: the Complications
In the presence of a very severe tracheitis, the internal edema of the trachea is severe to the point of drastically impairing the passage of air to the lungs. This results in a profound worsening of breathing difficulties and the appearance of cyanosis.
With the term "cyanosis", doctors indicate the condition in which the blood contains an insufficient quantity of oxygen (N.B: it is an effect of the reduction of alveolar exchanges in the lungs) and the skin takes on a bluish-purplish color.
If the trachea undergoes a total occlusion and the help is not timely, a severe tracheitis can lead, first, to respiratory arrest and, subsequently, to the death of the patient.
Complications of Due Tracheitis Staphylococcus aureus
In case of tracheitis from Staphylococcus aureus, the patient could develop the so-called toxic shock syndrome (TSS), a multisystem inflammatory condition.
More common in women, TSS causes: high fever, dizziness (from hypotension), nausea, vomiting, diarrhea, sore throat, muscle aches, weakness, chills, bleeding problems and skin peeling.
Tracheitis: When To See Your Doctor?
A person should seek immediate medical advice if:
- The fever is very high and shows no signs of decreasing with the passing of the days;
- Breathing difficulties worsen, rather than improve;
- Cyanosis appears;
- The cough becomes more and more severe and there are serious difficulties in swallowing food.
However, doctors still usually resort to more specific examinations and tests, as it is their intention:
- Ascertain clinical suspicions and eliminate any doubts. Tracheitis causes symptoms similar to inflammation of the epiglottis, a condition better known as epiglottitis;
- Understanding the exact nature of the current tracheitis (whether it is bacterial, viral or non-infectious);
- Clarify the severity of the condition.
To achieve these three objectives, oximetry, culture tests on cells of the nasopharyngeal tract and sometimes also of the tracheal tract, radiography of the trachea and, sometimes, also endoscopy of the respiratory tract are essential.
What is Epiglottitis?
Inflammation of the epiglottis, or epiglottitis, is a delicate condition that can cause sudden airway obstruction and death.
Physical examination
The physical examination typically begins with an investigation aimed at clarifying the symptoms, during which the doctor asks the patient questions such as:
- What are the symptoms present?
- When did the first demonstrations appear? Did they arise after a particular circumstance?
- Did the symptoms get worse over the days or was there an improvement?
- Are there times of day when the ailments get worse?
After these questions, the physical examination continues with the medical evaluation of the patient's respiratory capacity (auscultation); this analysis is essential for identifying any difficulties or abnormal sounds during breathing (rattles, screeching, etc.).
Anamnesis
During the medical history, the doctor investigates the general state of health of the patient, his age, his habits, his family history, the city of residence, his work activity, if he suffers from any allergies, etc., with the "I intend to understand if there are relationships with the present symptoms.
The medical history establishes whether the patient is in a risk situation and whether it is justified to think about the presence of tracheitis.
Oximetry
The oximetry is a simple and straightforward test, which is used to measure the oxygen saturation in the blood.
Low blood oxygen saturation indicates that breathing difficulties (such as those that can induce tracheitis) are of some significance and deserve appropriate treatment.
Cultural Exams
Culture tests on a sample of appropriately collected nasopharyngeal or tracheal cells allow to clarify two aspects:
- Establish if the patient suffers from any bacterial infection (remember that bacteria are the main culprits of tracheitis);
- Identify the bacterium involved.
From a procedural point of view, culture tests consist of inoculating the cell sample in different culture media, each of which is suitable for the growth of a specific bacterium, and seeing where bacterial proliferation takes place.
The medium that allows bacterial growth indicates the responsible bacterium.
The identification of the responsible bacterium allows the doctor to plan the most appropriate treatment.
Culture test on a sample of cells from the nasopharyngeal tract
Immediate and not annoying, the collection of the nasopharynx cell sample takes place on the nasal mucosa or throat.
A "possible presence of bacteria in this site means that, probably, the tracheitis is of a secondary type (ie it derives from a form of rhinitis or pharyngitis).
Culture test on a sample of cells from the tracheal tract
The collection of the sample of tracheal cells is quite complex and requires the patient to be sedated, because otherwise the patient would feel pain.
Recourse to tracheal culture occurs only if strictly necessary; for example, when the symptoms are severe or when the doctor suspects a severe bacterial infection, for which it is essential to know the responsible agent.
X-ray of the Trachea (RX-Trachea)
An X-ray scan of the trachea provides a fairly clear picture of the duct that joins the larynx to the bronchi; therefore, it allows the doctor to outline the health of the tracheal duct and what induced the inflammation in it.
.The choice of antibiotics to be administered is up to the treating physician and depends on the bacterial agent that triggered the inflammation of the trachea (N.B: this is why the culture test is important).
So, secondly, it is good for the patient to follow some important medical indications, valid whenever an "infection is present, such as: absolute rest for a few days, constant intake of fluids to avoid dehydration phenomena and the intake of non-inflammatory drugs. steroid drugs (NSAIDs) to relieve symptoms.
Viral Tracheitis: How to Treat It?
A viral tracheitis does not usually require special pharmacological treatments; in fact, it is very rare, in these situations, for doctors to administer antiviral drugs.
Since viral tracheitis is an "infection, the" observance of the medical indications mentioned above "is of fundamental importance for bacterial tracheitis, that is: absolute rest, constant supply of liquids to avoid any episodes of dehydration and NSAID intake to reduce the symptomatology.
Allergen Tracheitis: How Is It Treated?
The treatment of tracheitis due to allergens involves, first of all, the identification of the triggering factor and its exclusion from the environment in which the patient usually lives; after which, it includes the use of antihistamines and / or cortisones, in order to reduce the allergic reaction.
Severe Tracheitis: What To Do?
Regardless of the causes, severe cases of tracheitis require immediate hospitalization because patients need respiratory support.
This respiratory support occurs through the insertion, in the patient's trachea, of an endotracheal tube, connected to a machine for mechanical ventilation.
The use of respiratory aid ends when the patient demonstrates clear improvements and is able to breathe independently and with good results.
During hospitalization, the medical staff administers drugs to the patient (antibiotics, if the tracheitis is bacterial, anti-inflammatory, etc.) and checks his vital parameters, such as heart rate, oxygen saturation, etc.).
Tracheitis: Natural Remedies
In the presence of tracheitis, it is important to drink a lot, not to smoke, to eat a lot of fruits and vegetables, and to avoid too large meals.
Furthermore, the use of water and salt based fumigations and preparations based on natural substances, such as propolis, chamomile, eucalyptus, echinacea and mallow, can benefit the body.
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