Cough-induced rib fracture in a smoker: a case report
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(2020) 14:147
CASE REPORT
Open Access
Cough-induced rib fracture in a smoker: a case report Aimee Daccache1*, Jad Haddad1, Ahmad Ghanem1, Elio Junior Feghali1 and Bassel El Osta2
Abstract Background: Coughing is considered an important mechanism that helps the body get rid of foreign substances or prevent their entry into the tracheobronchial tree. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four. Case presentation: In this report, we present a case of a healthy 50-year-old Lebanese smoker who developed a total of six fractures in five ribs, asymmetrically, after coughing for 2.5 months. Conclusion: This case report is, to our knowledge, the first to describe six cough-induced rib fractures in a smoker without an underlying predisposition. Keywords: Cough, Rib fracture, Chest pain
Introduction Coughing is considered an important mechanism that helps rid the body of foreign substances or prevent their entry into the tracheobronchial tree [1]. Coughing is often self-limited and uncomplicated. However, when severe, it can be associated with pneumothorax, pulmonary herniation, or rib fractures [2]. Most commonly, rib fractures are caused by a thoracic injury. Infrequently, after the onset of coughing, patients presenting with persistent chest pain are found to have rib fractures [3]. Previous studies showed that cough-induced rib fractures occurred most frequently on the lateral side of the fifth through ninth ribs [1], with the sixth rib being the most common site [4]. Among the cases reported for cough-induced rib fractures, the maximum number of fractured ribs was found to be four [3]. In this report, we present a case of an otherwise healthy 50-year-old patient who developed a total of six fractures in five ribs, asymmetrically, after coughing for * Correspondence: [email protected] 1 Gilbert and Rose-Marie Chagoury School of Medicine, Blat, Lebanon Full list of author information is available at the end of the article
2.5 months. The uniqueness of this report is its description of the oddly large number of rib fractures involved in a healthy smoker with no relevant history of diseases. This case report may prompt attention to the importance of addressing the issue of cough-induced rib fracture and of dealing with chronic cough to avoid such complications.
Case presentation A 50-year-old Lebanese man presented to our hospital for ongoing chest pain of 2.5 months’ duration felt upon coughing, sneezing, or laughing. The patient had experienced a mild episode of self-limited bronchitis 3 months ago for 1 week, after which he developed constant, dry, nonproductive cough and chest pain. In the patient’s past medical history, chest trauma, chronic diseases, and allergies to any medication were absent. With regard to his social and professional history, the patient is a wealthy businessman who works in Saudi Arabia. He does
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