TRAKEITIS

adalah suatu infeksi/peradangan disebabkan

oleh bakteri yangmenyebabkan obstruksi jalan
napas, sepsis, dan kematian. Insiden tertinggi
pada usia 3 – 8 tahun
Gejala Klinik:
 Diawali dengan Infeksi Saluran Napas Atas
 Stridor inspiratoar (dapat disertai pula dengan stridor
ekspiratoar)
 Batuk menggonggong (barklike or brassy cough)
 Respiratory disstres dalam derajat yg bervariasi (Retractions,
Dyspnea, Nasal flaring, Cyanosis)
 Perasaan tdk enak/sakit di tenggorokan, sakit menelan
 Suara serak
 Demam
 Tdk ditemukan drooling
 Gangguan jalan napas disebabkan oleh obstruksi sal napas oleh
secret purulent.
 Bila terjadi multiorgan failure : biasanya disebabkan oleh
eotoxin-producing strains of Staphylococcus aureus atau
Streptococcus pyogenes
Penyebab:
 Staphylococcus aureus
 S pyogenes, Streptococcus pneumoniae, dan beberapa spesies
alpha hemolytic streptococcal
 Moraxella catarrhalis
 Haemophilus influenzae type B (Hib):
 Klebsiella species, Pseudomonas species
 Anaerobes
 Peptostreptococcus species, Bacteroides species
 Prevotella species
 Yang lain : Mycoplasma pneumoniae, Mycobacterium tuberculosis
(endobronchial disease), H1N1 influenza
Laboratory Studies
- Pem. Lab : Peningkatan Leukosit
- Pem. Kultur dan Pewarnaan Gram dapat dilakukan pada
kecurigaan trakeitis bakterial

Imaging Studies
Pada Pemeriksaan Foto Polos Ro dapat terlihat :
- Potongan AP : Penyempitan subglottic (Steeple sign)
 Potongan Leteral : Perkabutan atau tepi kolum trakea yang
iregular
Normal Ro Steeple sign
Differential Diagnoses
 Croup
 Pediatric Angioedema
 Pediatric Candidiasis
 Pediatric Diphtheria
 Pediatric Epiglottitis
 Pediatric Peritonsillar Abscess
 Pediatric Tuberculosis
 Retropharyngeal Abscess
Penatalaksanaan :
 Airway
o Mempertahankan jalan napas yang adekuat !!!!
o Hindari anak menjadi gelisah
o Jika dibutuhkan intubation, gunakan ETT ukuran 0.5-1
o Pengisapan lendir yang sering disertai dengan pemberian
O2 dengan kelembaban tinggi
Penatalaksanaan :
 Medikamentosa
o Bila jalan napas sdh stabil diberikan obat2an secara i.v.
o Regimen AB :cephalosporin, penicillinase-resistant penicillin (eg,
oxacillin, nafcillin).
o Clindamycin (40 mg/kg/d intravenously [IV], divided every 8 h)
digunakan pada kasus yg resisten penisilin
o Vancomycin (45 mg/kg/d IV, divided every 8 h), dapat dikombinasi
dengan Clindamycin pada kasus kasus multiorgan failure
Pembedahan
Tracheostomy : pada pasien yang gagal ekstubasi atau pada pasien
dengan prolonged intubation.

Rujuk :
 Otorhinolaryngologist – Untuk prosedur endoskopik dan
penanganan akut jalan napas
 Pediatric intensivist – bila terlihat potensi terjadinya
dekompensasi akut..penting !!!!
Komplikasi :
 Pneumonia – Terjadi pada 19-60% kasus
 Septicemia
 Toxic shock
 Adult respiratory distress syndrome (ARDS)
 Endotracheal tube complications
o Plugging, accidental extubation
o Postextubation stridor, subglottic stenosis
 Cardiorespiratory arrest
Prognosis
Jika pasien dapat melewati fase akut, prognosisinya
baik.

Edukasi :
Imunisasi
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