What could it be? A bad vitamin-ey smell in nose and trach cannula? Have been taking inhaled tobramycin and cefepime through picc line for pneumonia and have been off them both for 8 days.

What. What other medical problems do you have? Why do you have a tracheostomy tube? What was the offending bacteria causing your pneumonia? Most importantly--how are your symptoms? Fever, breathing ok, sputum from your trach tube? As an otolaryngologist, I have a lot of experirnce with nasal/sinus issues and trach tubes. My guess is that you are recovering from a significant insult to your respiratory tract. The organisms that were treated are likely gone, but you are left with the aftermath. The lungs are likely transiently damaged and need to recover. That can include the mucociliary clearance of the mucous produced normally in the lungs as well as byproducts of the infection--these can all lead to abnormal smell from the respiratory tract. For you now, pulmonary toilet (the actions you do to cealn out your lungs, trachea, and tracheostomy tube) is going to be very imortant to clean all that "crud" out. Deep coughing and deep suction with saline "spritzes" are important, nebulized saline will loosen the secretions and allow for easier clearance. Saty hydrated. If you are having worsening symptoms, see your doctor. He or she may be able to stop a situation from getting worse and keep you out of an er or from getting admitted to the hospital.