Tracheobronchitis is inflammation of the

trachea The trachea (: tracheae or tracheas), also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all animals' lungs. The trachea extends from ...

and

bronchi A bronchus ( ; : bronchi, ) is a passage or airway in the lower respiratory tract that conducts air into the lungs. The first or primary bronchi to branch from the trachea at the carina are the right main bronchus and the left main bronchus. Thes ...

. It is characterised by a cough, fever, and purulent (containing pus)

sputum Sputum is mucus that is coughed up from the lower airways (the trachea and bronchi). In medicine, sputum samples are usually used for a naked-eye examination, microbiological investigation of respiratory infections, and Cytopathology, cytological ...

and is therefore suggestive of

pneumonia Pneumonia is an Inflammation, inflammatory condition of the lung primarily affecting the small air sacs known as Pulmonary alveolus, alveoli. Symptoms typically include some combination of Cough#Classification, productive or dry cough, ches ...

. It is classified as a respiratory tract infection. Tracheobronchitis is often a

hospital-acquired infection A hospital-acquired infection, also known as a nosocomial infection (from the Greek , meaning "hospital"), is an infection that is acquired in a hospital or other health care, healthcare facility. To emphasize both hospital and nonhospital sett ...

, particularly in an intensive care setting, associated with the use of mechanical ventilators, and the need for inserting a

tracheal tube A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide. Many different types of tracheal tubes are ...

. In these cases it is known as ventilator-associated tracheobronchitis. The infection begins in the trachea where it colonises and spreads to the bronchi. The characteristic increased sputum produced can give problems in the removal of the tracheal tube (extubation). Tracheobronchial infections are responsible for up to 80% of exacerbations in

chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by chronic respiratory symptoms and airflow limitation. GOLD defines COPD as a heterogeneous lung condition characterized by chronic respiratory s ...

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Causes

Ventilator-associated tracheobronchitis is a

usually contracted in an

intensive care unit An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine. An inten ...

when a

mechanical ventilator A ventilator is a type of breathing apparatus, a class of health technology, medical technology that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to ...

is used. The insertion of a tracheal tube can cause an infection in the trachea which then colonises and spreads to the

. If there is further spread and development into the lungs this will give rise to

ventilator-associated pneumonia Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (I ...

. Antibiotics are recommended to prevent this development but only as a short term measure as antibiotic resistance is already high in some of the pathogens involved. This does not always progress to pneumonia. Fungal tracheobronchitis can be invasive into the lung tissue or pulmonary artery and cause a severe lung infection. The extra secreted mucus from tracheobronchitis plugs the airways allowing the fungal pathogens to lodge and multiply. Local damage to the tracheal wall that can be caused by mechanical ventilation is a risk factor for this. Respiratory failure may develop from this infection. Herpetic tracheobronchitis is caused by

herpes simplex virus Herpes simplex virus 1 and 2 (HSV-1 and HSV-2) are two members of the Herpesviridae#Human herpesvirus types, human ''Herpesviridae'' family, a set of viruses that produce Viral disease, viral infections in the majority of humans. Both HSV-1 a ...

and causes small ulcers covered in exudate to form on the mucous membranes. The exudate contains necrotic cells from the mucosal epithelium. The characteristic increased sputum produced can give problems in the removal of the tracheal tube (extubation). In the course of

cystic fibrosis Cystic fibrosis (CF) is a genetic disorder inherited in an autosomal recessive manner that impairs the normal clearance of Sputum, mucus from the lungs, which facilitates the colonization and infection of the lungs by bacteria, notably ''Staphy ...

the lungs are affected. Thickened mucus secretions block the airways making infection possible. The recurrence of tracheobronchitis presents a major problem. In

tracheobronchial infections are responsible for up to 80% of exacerbations.

In dogs

Tracheobronchitis often affects dogs particularly those confined in kennels where their persistent barking worsens the inflammation. This ''canine infectious tracheobronchitis'' is more usually known as kennel cough.

References

{{Reflist Respiratory diseases