Case Presentation: A 14-year-old boy with no significant medical history presented to the emergency department with a sudden onset of debilitating left-sided chest pain and severe dyspnea. The symptoms began acutely while he was at rest, approximately 1 hour before arrival. During a coughing fit, he expectorated a small amount of clear, watery, and distinctly bitter-tasting fluid. His medical background was unremarkable, with no history of prior respiratory symptoms, asthma, smoking, recent trauma, or chronic illnesses. The patient lives in a rural village, has no travel history, and has no special dietary habits that would predispose him to a different diagnosis.
Özgökçe et al. (Sun,) studied this question.