Interesting Case of Cough Fracture in an Adult

Abstract

A 32-year-old man, a known case of bronchial asthma was presented to our emergency department with chief complaint of sudden onset pain in the left lower chest wall after strong paroxysmal coughing due to aggravation of bronchial asthma symptoms. Chest pain was localised and aggravated with respiration without any radiation. There was no history of fever, abdominal pain, nausea and vomiting, diaphoresis or orthopnoea. History of any thoracic trauma, cardiac disease or osteoporosis due to chronic renal disease or any metabolic disease was not present. He was on intermittent oral and inhalational corticosteroid therapy, because of the uncontrolled bronchial asthma for last five years. On physical evaluation, he was tachypnoeic and vital was normal. He had tenderness over his left lower chest wall. Diffuse rhonchi were heard over both lung fields on auscultation. Cough is generally self-limited and uncomplicated, but can be associated with complications, particularly when it is paroxysmal and violent. Rib fracture is among the uncommon complications of cough. In this article, we report a case of 32year-old male who presented with complaints of acute chest pain after paroxysmal coughing and was diagnosed with cough fracture of the ninth rib on subsequent workup. Rib fracture in otherwise healthy young individual after coughing is not common. The purpose of this case report is to call attention on rib fracture as infrequent and often an unrecognised cause of sudden chest pain, so that it should be considered as differential diagnosis of acute chest pain after common causes. Coughing is a crucial defense mechanism in respiratory system and is usually uncomplicated, but sometimes can be with complications, especially when chronic. One of these complications is rib fracture. 1 In this case report, we present a case of cough fracture in young patient.