When the trachea gets infected, it’s almost always due to a virus. Patients have a barking cough, no runny nose, and normal lung exam by stethoscope. In children under 3, we call it croup; they can get significantly short of breath, because the trachea is narrow (see Diagram — Upper Respiratory Tract). In older persons, it’s just a nasty cough.
This is one time I suggest cough syrup, especially at night to help patients sleep. In general, cough medicine interferes with our defenses — coughing keeps things out of the lungs, so if we suppress it, there’s more chance of pneumonia. The main disease that resembles tracheitis is Pertussis (“whooping cough”). We might think of this if coughing spells are so severe that the person vomits, or if the cough is going on toward 2 weeks without starting to improve even a little. We worry most about this if the patient is around infants too young to be vaccinated (or whose parents are anti-vaccine for whatever reason), because babies are who can die from Pertussis.