Severe Coughing Leading to Rib Pain: When to Seek Medical Help

Coughing to the point of rib pain?

Hello Doctor, I have had a cold for about two weeks.
Since I am in Europe, it is quite inconvenient to seek medical care, so I have been relying on over-the-counter medications.
I have had respiratory issues since childhood, and every time I catch a cold, I end up with a prolonged and severe cough, sometimes to the point of muscle strain.
This time, I have been coughing for two weeks.
I have been drinking hot water and taking cough syrup regularly, but it doesn't seem to help much.
The phlegm is difficult to expel and is green in color.
The severity of my cough is quite significant; sometimes, I hear a "bubbling" sound in my throat while coughing, which makes me worry that it might be a ruptured alveolus.
Last week, I coughed so hard that I strained my abdominal muscles, and today I started experiencing sharp pain under my right rib cage when I cough.
It hurts to touch, and even slight movements cause pain.
I have to hold my body while coughing, or it feels like I might split open.
I am very concerned that I might have cracked a rib from all the coughing.
Additionally, I have been experiencing intermittent fevers for several days, fluctuating between good and bad.
My nasal discharge has been thick and yellow, running continuously for four to five days.
I have also lost my sense of smell and taste; could this be caused by the fever? Should I go to the hospital for an X-ray of my ribs? My persistent cough is not improving; what should I do? Thank you, Doctor, and I appreciate your response.

Cheng, 20~29 year old female. Ask Date: 2016/01/31

Dr. Zhang Ziyan reply Pulmonology

Hello, the cause of the pain may still be due to a few infections or more serious possibilities.
If the symptoms persist, please seek medical attention, and consult with a physician for an accurate diagnosis and treatment.
Changhua Hospital cares about you.

Reply Date: 2016/01/31

More Info

Based on your description, it sounds like you are experiencing a severe respiratory illness that has persisted for two weeks, characterized by a persistent cough, rib pain, and other concerning symptoms. Given the complexity of your situation, it is crucial to address your concerns comprehensively.

First and foremost, the presence of a severe cough lasting more than two weeks, especially if accompanied by green phlegm, fever, and rib pain, warrants immediate medical attention. These symptoms could indicate a bacterial infection, such as pneumonia or bronchitis, which may require specific treatment beyond over-the-counter medications. The green color of your phlegm suggests that there may be an infection, as this is often associated with bacterial rather than viral infections.

The rib pain you are experiencing could be due to muscle strain from intense coughing, but it is also essential to rule out any potential rib fractures or other serious conditions. Coughing can indeed lead to muscle strain, and in some cases, it can cause rib injuries, especially if the cough is forceful and persistent. The "popping" sound you hear when you cough could be related to air moving in and out of the lungs or even the sound of your ribcage responding to the strain of coughing. However, it is crucial to have this evaluated by a healthcare professional to ensure there are no fractures or other complications.

Your symptoms of intermittent fever and the loss of taste and smell are also concerning. While loss of taste and smell can be associated with viral infections, including COVID-19, the combination of fever, cough, and green phlegm suggests a more complex respiratory issue that may not be solely viral in nature. Given the current global health context, it is advisable to consider testing for COVID-19 and other respiratory pathogens, especially if you have been in contact with individuals who have tested positive.

In terms of next steps, I strongly recommend seeking medical attention as soon as possible. An evaluation by a healthcare provider is necessary to perform a thorough examination, which may include:
1. Chest X-ray: This will help identify any potential pneumonia, pleural effusion (fluid around the lungs), or rib fractures.

2. Blood tests: These can help assess for infection and inflammation in your body.

3. Sputum culture: If you are able to produce phlegm, a sample can be tested to identify the specific bacteria causing your symptoms, which will guide appropriate antibiotic therapy.

4. Pulmonary function tests: Given your history of respiratory issues, these tests can help evaluate your lung function and determine if there are underlying conditions such as asthma or chronic bronchitis.

While you are managing your symptoms with over-the-counter medications and home remedies, it is essential to understand that these may not be sufficient to address a potential bacterial infection. Antibiotics may be necessary if a bacterial infection is confirmed.

In summary, given the severity and duration of your symptoms, it is crucial to seek medical attention promptly. Do not hesitate to visit a healthcare facility where you can receive a comprehensive evaluation and appropriate treatment. Your health and well-being are paramount, and addressing these symptoms early can prevent further complications.

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