The most common cause of stridor in children presenting to emergency departments during the fall and winter is viral laryngotracheobronchitis, or croup. 1 Miranda A Valdez T Pereira K Bacterial tracheitis: a varied entity. Pediatr Emerg Care. 2011; 27: 950-953 Crossref PubMed Scopus (10) Google Scholar However, bacterial tracheitis, a rare upper airway infectious disease, has recently emerged as the most common life-threatening upper airway infection in children. 2 Hopkins A Lahiri T Salerno R Heath B Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics. 2006; 118: 1418-1421 Crossref PubMed Scopus (68) Google Scholar In their article on the re-emergence of bacterial tracheitis, Hopkins et al 2 Hopkins A Lahiri T Salerno R Heath B Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics. 2006; 118: 1418-1421 Crossref PubMed Scopus (68) Google Scholar announced that “the epidemiology of potentially life-threatening upper airway infections is changing.” This change is partially due to the introduction of the Haemophilus influenzae type b (Hib) vaccine, which has contributed to a decreased incidence of epiglottitis. 3 Zoorob R Sidani M Murray J Croup: an overview. Am Fam Physician. 2011; 83: 1067-1073 PubMed Google Scholar The results of a 9-year retrospective study of pediatric patients (n = 107) with potentially life-threatening upper airway infections by Hopkins et al 2 Hopkins A Lahiri T Salerno R Heath B Changing epidemiology of life-threatening upper airway infections: the reemergence of bacterial tracheitis. Pediatrics. 2006; 118: 1418-1421 Crossref PubMed Scopus (68) Google Scholar demonstrated that bacterial tracheitis was 3 times more likely to have caused respiratory failure than both viral croup and epiglottitis combined. Elizabeth Stone Griffin is Staff Nurse IV, Children’s Emergency Department, WakeMed Health & Hospitals, Raleigh, NC, and Clinical Faculty, School of Nursing, University of North Carolina–Chapel Hill, Chapel Hill, NC. Tiffany Young is Staff Nurse IV, WakeMed Health & Hospitals, Raleigh, NC, and Pediatric Nurse Practitioner, Nash General Hospital, Rocky Mount, NC.