Empyema associated with a cough-induced rib fracture

Abstract

A 44-year-old man presented to the emergency department with fever and right anterior chest pain. He reported a persistent cough and the development of sudden-onset right anterior chest pain after coughing. The inspiratory pain in the right lung was severe, and therefore deep breathing was impossible. Chest CT revealed a fracture in the right seventh rib with consolidation and pleural effusion. A pleural fluid culture test result was positive for methicillin-susceptible Staphylococcus aureus. He was diagnosed with empyema associated with a cough-induced rib fracture. Thoracic drainage tube placement and intravenous antibiotic therapy successfully ameliorated his condition. He was discharged on day 13 and switched to an 8-week course of oral antibiotic therapy. There was no clinical relapse at the 6-month follow-up.

Cough-induced rib fractures: A comprehensive analysis of 90 patients in a single center

“…However, Hanak et al[ 2 ] reported several pathologies related to CIRF including hemothorax, pneumomediastinum, subcutaneous emphysema, chest wall hematoma, and intercostal pulmonary herniation in 14.8% of their patients. Other reported accompanying pathologies related to CIRF included diaphragmatic rupture and abdominal visceral herniation into the thoracic cavity,[ 3 , 5 , 15 ] empyema,[ 4 ] and pneumothorax. [ 6 ]…”

“…However, Hanak et al [2] reported several pathologies related to CIRF including hemothorax, pneumomediastinum, subcutaneous emphysema, chest wall hematoma, and intercostal pulmonary herniation in 14.8% of their patients. Other reported accompanying pathologies related to CIRF included diaphragmatic rupture and abdominal visceral herniation into the thoracic cavity, [3,5,15] empyema, [4] and pneumothorax. [6] We demonstrated the most frequently fractured rib was the sixth rib, similar to the study of Hanak et al [2] Contrary to this, the 10 th rib was the most fractured one according to Sano et al [12] In general, CIRF mostly affect the fourth to ninth ribs.…”

“…[2] Nevertheless, the literature data about cough-induced rib fractures (CIRFs) have been sparse and limited primarily to case reports. [1,[3][4][5][6][7][8] In the present study, we aimed to evaluate patients with CIRFs according to demographic characteristics, underlying pathology, radiological features of CIRF, treatment results, and complications.…”