Exudative tracheitis, membranous or pseudomembranous croup, membranous laryngotracheobronchitis
Membranous croup: Confusing term overlapping much more common benign entity of viral croup
Definitions
Purulent infection of trachea
Results in thick, adherent, exudative plaques along tracheal walls with pseudomembranes extending across lumen
Plaques can slough & obstruct airway
Controversial disease
More frequent in certain medical centers; rarely seen in other centers of similar climate
While many cases with significant morbidity/mortality have been confirmed, questions remain concerning overdiagnosis/overtreatment at some centers
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Akhavan M: Ear, Nose, Throat: Beyond pharyngitis: retropharyngeal abscess, peritonsillar abscess, epiglottitis, bacterial tracheitis, and postoperative tonsillectomy. Emerg Med Clin North Am. 39(3):661-75, 2021
Barengo JH et al: Demographic characteristics of children diagnosed with bacterial tracheitis. Ann Otol Rhinol Laryngol. 34894211007250, 2021
Casazza G et al: Pediatric bacterial tracheitis-a variable entity: case series with literature review. Otolaryngol Head Neck Surg. 160(3):546-9, 2019
Blot M et al: Update on childhood and adult infectious tracheitis. Med Mal Infect. 47(7):443-52, 2017
Darras KE et al: Imaging acute airway obstruction in infants and children. Radiographics. 35(7):2064-79, 2015
Kuo CY et al: Bacterial tracheitis. Pediatr Rev. 35(11):497-9, 2014
Miranda AD et al: Bacterial tracheitis: a varied entity. Pediatr Emerg Care. 27(10):950-3, 2011
Sammer M et al: Membranous croup (exudative tracheitis or membranous laryngotracheobronchitis). Pediatr Radiol. 40(5):781, 2010
Shargorodsky J et al: Bacterial tracheitis: a therapeutic approach. Laryngoscope. 120(12):2498-501, 2010
Huang YL et al: Bacterial tracheitis in pediatrics: 12 year experience at a medical center in Taiwan. Pediatr Int. 51(1):110-3, 2009
Lee JK et al: Treatment of exudative tracheitis with acute airway obstruction under jet ventilation. Otolaryngol Head Neck Surg. 139(4):606-7, 2008
Salamone FN et al: Bacterial tracheitis reexamined: is there a less severe manifestation? Otolaryngol Head Neck Surg. 131(6):871-6, 2004
Rotta AT et al: Respiratory emergencies in children. Respir Care. 48(3):248-58; discussion 258-60, 2003
Stroud RH et al: An update on inflammatory disorders of the pediatric airway: epiglottitis, croup, and tracheitis. Am J Otolaryngol. 22(4):268-75, 2001
Damm M et al: Management of acute inflammatory childhood stridor. Otolaryngol Head Neck Surg. 121(5):633-8, 1999
Bernstein T et al: Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit. Clin Infect Dis. 27(3):458-62, 1998
Brody AS et al: Membranous tracheitis: how accurate is the plain film diagnosis? Pediatr Radiol (Abstr). 27:705, 1997
Brook I: Aerobic and anaerobic microbiology of bacterial tracheitis in children. Pediatr Emerg Care. 13(1):16-8, 1997
Britto J et al: Systemic complications associated with bacterial tracheitis. Arch Dis Child. 74(3):249-50, 1996
John SD et al: Stridor and upper airway obstruction in infants and children. Radiographics. 12(4):625-43; discussion 644, 1992
Han BK et al: Membranous laryngotracheobronchitis (membranous croup). AJR Am J Roentgenol. 133(1):53-8, 1979
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
Exudative tracheitis, membranous or pseudomembranous croup, membranous laryngotracheobronchitis
Membranous croup: Confusing term overlapping much more common benign entity of viral croup
Definitions
Purulent infection of trachea
Results in thick, adherent, exudative plaques along tracheal walls with pseudomembranes extending across lumen
Plaques can slough & obstruct airway
Controversial disease
More frequent in certain medical centers; rarely seen in other centers of similar climate
While many cases with significant morbidity/mortality have been confirmed, questions remain concerning overdiagnosis/overtreatment at some centers
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Akhavan M: Ear, Nose, Throat: Beyond pharyngitis: retropharyngeal abscess, peritonsillar abscess, epiglottitis, bacterial tracheitis, and postoperative tonsillectomy. Emerg Med Clin North Am. 39(3):661-75, 2021
Barengo JH et al: Demographic characteristics of children diagnosed with bacterial tracheitis. Ann Otol Rhinol Laryngol. 34894211007250, 2021
Casazza G et al: Pediatric bacterial tracheitis-a variable entity: case series with literature review. Otolaryngol Head Neck Surg. 160(3):546-9, 2019
Blot M et al: Update on childhood and adult infectious tracheitis. Med Mal Infect. 47(7):443-52, 2017
Darras KE et al: Imaging acute airway obstruction in infants and children. Radiographics. 35(7):2064-79, 2015
Kuo CY et al: Bacterial tracheitis. Pediatr Rev. 35(11):497-9, 2014
Miranda AD et al: Bacterial tracheitis: a varied entity. Pediatr Emerg Care. 27(10):950-3, 2011
Sammer M et al: Membranous croup (exudative tracheitis or membranous laryngotracheobronchitis). Pediatr Radiol. 40(5):781, 2010
Shargorodsky J et al: Bacterial tracheitis: a therapeutic approach. Laryngoscope. 120(12):2498-501, 2010
Huang YL et al: Bacterial tracheitis in pediatrics: 12 year experience at a medical center in Taiwan. Pediatr Int. 51(1):110-3, 2009
Lee JK et al: Treatment of exudative tracheitis with acute airway obstruction under jet ventilation. Otolaryngol Head Neck Surg. 139(4):606-7, 2008
Salamone FN et al: Bacterial tracheitis reexamined: is there a less severe manifestation? Otolaryngol Head Neck Surg. 131(6):871-6, 2004
Rotta AT et al: Respiratory emergencies in children. Respir Care. 48(3):248-58; discussion 258-60, 2003
Stroud RH et al: An update on inflammatory disorders of the pediatric airway: epiglottitis, croup, and tracheitis. Am J Otolaryngol. 22(4):268-75, 2001
Damm M et al: Management of acute inflammatory childhood stridor. Otolaryngol Head Neck Surg. 121(5):633-8, 1999
Bernstein T et al: Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit. Clin Infect Dis. 27(3):458-62, 1998
Brody AS et al: Membranous tracheitis: how accurate is the plain film diagnosis? Pediatr Radiol (Abstr). 27:705, 1997
Brook I: Aerobic and anaerobic microbiology of bacterial tracheitis in children. Pediatr Emerg Care. 13(1):16-8, 1997
Britto J et al: Systemic complications associated with bacterial tracheitis. Arch Dis Child. 74(3):249-50, 1996
John SD et al: Stridor and upper airway obstruction in infants and children. Radiographics. 12(4):625-43; discussion 644, 1992
Han BK et al: Membranous laryngotracheobronchitis (membranous croup). AJR Am J Roentgenol. 133(1):53-8, 1979
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