For one 66-year-old woman, what started as a quest for relief from a persistent dry cough ended with a pertussis diagnosis and the discovery that she'd fractured one of her ribs. And her case ended up in the New England Journal of Medicine earlier this month.

The woman, who has not been identified by name, visited her primary care provider, John Zambrano, M.D., a physician at a Boston-based Atrius Health practice, (Harvard Vanguard Medical Associates), after experiencing a series of violent, painful coughing fits over a two-week period. She'd previously been to a local urgent care center, Dr. Zambrano tells SELF, where she'd been treated for a common cold.

But when she told Dr. Zambrano that her symptoms hadn't let up, he suspected she had pertussis—or whooping cough—a respiratory disease that causes violent, sometimes uncontrollable coughing. She also complained of pain in her right side.

A lab test confirmed Dr. Zambrano's pertussis suspicion, and a CAT scan revealed the woman had fractured her rib, likely while coughing. The scan also showed that a piece of the woman's liver had ended up in her lungs, likely, again, during one of her coughing fits.

Pertussis, aka "whooping cough," is an infection caused by the Bordetella pertussis bacteria. It attaches to the cilia (little hair-like structures that line your windpipe) and causes your airways to swell, the CDC explains

That inflammation can make it harder to breathe and lead to coughing fits that force air out of the body. These coughing fits can be "very intense" and can last up to a couple minutes, Dr. Zambrano says.

Obviously, this can be frightening for the person doing the coughing, as well as the people around them. Not only can the attacks be pretty violent (read: hard to watch), but the bacteria is also highly contagious and airborne—meaning it can be transferred through coughing, sneezing, and generally breathing the same air as someone with the infection.

Once a coughing fit is over and someone tries to breathe back in, they might produce a "whooping" sound. This is evidence of what Dr. Zambrano calls a "strong inspiratory effort"—basically, proof that you just lost a lot of air and you're having a hard time breathing some back in.

It turns out that cracking a rib thanks to a cough happens more often than you might think. But it's still pretty rare.

"You can crack ribs if you have asthma, pneumonia, or pretty much anything that's going to generate a chronic, intense cough," Dr. Zambrano says.

He points to a study published in 2005 in Mayo Clinic Proceedings. For the study, researchers went on a hunt to find every case of a patient who developed a rib fracture associated with a severe cough who had gone to the Mayo Clinic location in Rochester, Minnesota over a nine-year period (between 1996 and 2005). The researchers turned up 54 cases, 78 percent of whom were female.

That's not nothing, but only 54 patients in nine years doesn't exactly suggest we all need to be worried about an imminent rib fracture whenever we get a cough.

If your cough is new and persistent, you should check in with your doctor.

Coughs in general are a normal strategy that your body uses to get rid of something that's not supposed to be in your airways. But when a cough doesn't go away after a few weeks or it brings up bloody or discolored mucus, that should definitely be checked out, the Mayo Clinic explains.