Laughing so hard your sides split is one thing, but one woman has actually coughed so hard she broke a rib.
When the 66-year-old woman, from the US state of Massachusetts, who has not been named in the report published in the New England Journal of Medicine, first went to see her doctor, it was thought she merely had the flu.
She had a dry cough for two weeks and a pain in her right side, but the treatment she was given for the flu did nothing to ease her symptoms.
When she went back to the doctor five days later, she lifted up her top to show a large dark mark on the right side of her torso, and it was clear there was another problem.
The woman, from Massachusetts, underwent a CT scan which revealed that she had a displaced fracture of her ninth rib – the rib had broken and the two ends had separated.
Further tests confirmed she had an infection with Bordetella pertussis, which causes whooping cough.
This was despite the fact that she had received a vaccine for the bug eight years earlier. The woman said she had not come into contact with anyone sick either.
Whooping cough is rarely serious in adults however in the most severe cases it can lead to complications such as rib fractures.
Initial symptoms include a runny nose, red and watery eyes, a sore throat, and a slightly raised temperature.
Intense bouts of coughing usually start about a week later.
The woman was given antibiotics and made a full recovery after undergoing surgery.
All clinic staff and close friends and family of the woman were also treated to ensure they wouldn’t catch the infection.