Fracture of the first rib as a consequence of pertussis infection

We report the first described case of a first rib fracture secondary to per tussis infection. An 11-year-old boy presented with sudden onset of severe right-sided pleuritic chest pain on a background of a 6 week history of a c oughing illness and considerable weight loss. Pertussis was clinically susp ected and proven on serology. A cause for the severe pain was initially dif ficult to confirm, causing some concern regarding possible underlying patho logy, but was later demonstrated to be due to a first rib fracture. The ana tomy of the first rib, and the biomechanical forces placed upon it that are exacerbated during a coughing illness are described.