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Bacterial Tracheitis Caused by Haemophilus influenzae after Influenza.

A 62-year-old woman with a history of bronchial asthma presented to the emergency department with dyspnea. Three days earlier, she had a cough, sore throat and a fever, and was diagnosed with influenza A. She started taking oseltamivir for influenza one day earlier. She was admitted to our hospital because of tachypnea with wheezing. We administered a systemic steroid to treat the patient’s bronchial asthma. Although her symptoms improved slightly, four days after admission, her cough worsened and she developed hoarseness. A chest X-ray did not indicate any evidence of pneumonia. An examination with a laryngofiberscope revealed that the mucosa of the trachea was reddish and swollen with purulent sputum (Picture A). Many gram negative coccobacilli, isolated as Haemophilus influenzae, were observed in the sputum. We diagnosed the patient with mild bacterial tracheitis (1) and started intravenous ceftriaxone. Four days after starting this treatment, her symptoms and larynx condition improved (Picture B) without any acute airway obstruction.