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June 1987

Roentgenographic Evaluation Bacterial Tracheitis

Author Affiliations

Washington, DC

Arch Otolaryngol Head Neck Surg. 1987;113(6):669. doi:10.1001/archotol.1987.01860060095025

To the Editor.—I was very interested in the report by Johnson and Liston1 about bacterial tracheitis in adults. At the Georgetown University–affilliated hospitals, adult patients with this entity are seen at the rate of two to three patients each year. I support Johnson and Liston's call to pursue the diagnosis, but in relying on the lateral soft-tissue view of the neck to demonstrate subglottic and tracheal edema, the authors overlook a wellknown radiologic fact: the best roentgenographic method with which to evaluate the airway in bacterial tracheitis and in croup, as opposed to epiglottitis, is to obtain a posteroanterior view of the neck. This is why subglottic edema usually appears "clouded," or fuzzy at best, on the lateral view, as can be seen in the roentgenograms used in the article.

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