In what has been described as a first-of-its-kind medical case, a man in his 30s ended up with a hole in his throat after pinching his nose and pressing his lips shut in order to surpress a sneeze.

The unnamed man was taken to Ninewells Hospital, in Dundee, Scotland, in severe pain, after trying to stifle a sneeze by pinching his nose and closing his mouth shut while driving. Apparently, when you do something like that, the pressure in the upper airways can increase by about 20 times, which can lead to serious injuries including ruptured eardrums, aneurysms, and even broken ribs. However, in this particular case, the unnamed patient ended up with a 2mm tear in their windpipe, which caused excruciating pain. A throat tear, known medically as a “spontaneous tracheal perforation” is a rare and potentially life-threatening injury that had not been associated with sneeze stifling before.

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In a report released on Tuesday, the journal BMJ Case Reports detailed the bizarre and somewhat frightening case of a 34-year-old British man who ruptured his throat by suppressing a particularly powerful sneeze. The man, described as “previously fit and well” attempted to politely contain his sneeze by “pinching the nose and holding his mouth closed”, which you are apparently not supposed to do.

The force of the sneeze backfired into his throat and perforated his pharynx, the part of the throat right above the larynx and esophagus. He was unaware of the damage initially, but after realizing that his voice had changed and his throat hurt when he swallowed, he knew something was wrong. His neck began to swell up as well, and whenever he moved his head, he experienced an unsettling sensation of popping and crackling.

The man went to the emergency department at Britain’s Leicester Royal Infirmary where doctors were able to diagnose his condition. X-rays revealed that the sneeze had ruptured his throat allowing air bubbles to make their way into the tissue and muscles of his chest, a condition known as subcutaneous emphysema and pneumomediastinum, which caused the popping sensation from his neck to extend all the way to his rib cage. Doctors had to take action quickly as the rupture left the man at risk for complications such as deep neck infection.

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Ira Saxena, a young girl from Colchester, England, can’t stop sneezing. From the moment she wakes up, she sneezes over 10 times per minute, and the unusual condition seems to be getting worse. Her mother is desperate to help, but doctors aren’t even sure what is causing the unusual sneezing bouts.

Ira’s mysterious condition kicked in one morning, three weeks ago, when Ira woke up and started sneezing. Her mother Priya says the sneezing wasn’t so bad at first, but it quickly progressed to a point where the girl wasn’t even able to attend school anymore. She now sneezes about 8,000 times per day, sometimes up to 10 times a minute, until she falls a sleep. “The one blessing is she sleeps fine, it is the only time when she is not sneezing and she can sleep right through the night,” her mother said.

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Meet Katelyn Thornley, a seventh grade student who spends most of her day sneezing. The 12-year-old from Angleton, Texas, suffers from an unknown condition that causes her to sneeze over 12,000 times a day, preventing her from enjoying a normal childhood.

The mysterious ailment started about three weeks ago, just after she left a clarinet lesson. “I just started in little spurts, sneezing,” Katelyn explained. “I thought it was like, I’m allergic to something or didn’t wash out my mouthpiece the right way.” But it soon snowballed into something a lot worse – about 20 sneezes a minute all day long, making it difficult for her to do anything at all. “I’m constantly in pain with my abdomen, my legs are weak, I can barely eat,” she said.

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