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October 23, 1972

Rectus Abdominal Muscles Pulled by Coughing

JAMA. 1972;222(4):486. doi:10.1001/jama.1972.03210040054018

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To the Editor.—  While practicing in Yuma, Ariz, I have seen two patients in the last six months who presented with pulled rectus abdominal muscle insertions over the symphysis pubis. Careful questioning of both patients revealed no history of trauma, but both patients had experienced antecedent, prolonged paroxysms of coughing. Both these patients, following evaluation, had pulmonary coccidioidomycosis confirmed by skin tests, x-ray films of the chest, and serum titers. I feel these patients demonstrate the importance of careful evaluation of possible pulmonary disease in patients with isolated pulled rectus abdominal muscles as their presenting complaint.