Which statement is true about bacterial tracheitis?

• A. It responds well to racemic epinephrine.
• B. It is a viral infection of the subglottic area.
• C. It presents with thick purulent secretions and a preceding viral infection.
• D. It is best treated with inhaled antibiotics.

Answer: (C)

Bacterial tracheitis is an acute bacterial infection of the trachea that often follows a viral upper respiratory illness. The key feature is thick, purulent secretions that can clog the airway, causing stridor and respiratory distress, sometimes more severely than the underlying illness would suggest. This pattern—a preceding viral illness with now thick, purulent secretions—is what makes that statement the best description.

Racemic epinephrine helps mainly in croup by reducing subglottic edema, not in bacterial tracheitis where the problem is purulent tracheal secretions and bacterial invasion, so that response isn’t reliable here. It isn’t a viral infection of the subglottic area, which would describe croup rather than bacterial tracheitis. And inhaled antibiotics aren’t the standard treatment for this condition, where systemic antibiotics and airway management are the mainstays.