Bacterial tracheitis is most often caused by the bacteria Staphylococcus aureus. It often follows a viral upper respiratory infection. It affects mostly young children. This may be due to their tracheas being smaller and more easily blocked by swelling.

Symptoms include:

• Deep cough (similar to that caused by croup)
• Difficulty breathing
• High fever
• High-pitched breathing sound (stridor)

The health care provider will perform a physical exam and listen to the child's lungs. The muscles between the ribs may pull in as the child tries to breathe. This is called intercostal retractions.

Tests that may be done to diagnose this condition include:

• Blood oxygen level
• Nasopharyngeal culture to look for bacteria
• Tracheal culture to look for bacteria
• X-ray of the trachea or neck
• Tracheoscopy

The child often needs to have a tube placed into the airways to help with breathing. This is called an endotracheal tube. Bacterial debris often needs to be removed from the trachea at that time.

The child will receive antibiotics through a vein. The health care team will closely monitor the child's breathing and use oxygen, if needed.

With prompt treatment, the child should recover.

Complications may include:

• Airway obstruction (can lead to death)
• Toxic shock syndrome if the condition was caused by the bacteria staphylococcus

Tracheitis is an emergency medical condition. Go to the emergency room right away if your child has had a recent upper respiratory infection and suddenly has a high fever, a cough that gets worse, or trouble breathing.

Bacterial tracheitis; Acute bacterial tracheitis

Bearman GM, Wenzel RP. Acute bronchitis and tracheitis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 84.

Cai Y, Meyer A. Pediatric infectious disease. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 201.

Rodrigues KK, Roosevelt GE. Acute inflammatory upper respiratory obstruction (croup, epiglottitis, laryngitis, and bacterial tracheitis). In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 433.

Rose E. Pediatric respiratory emergencies: upper airway obstruction and infections. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 162.

Updated by: Ashutosh Kacker, MD, FACS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.