A devoted One Direction fan found herself in hospital with a collapsed lung after screaming at one of the band’s concerts.
The unnamed 16-year-old, who has since recovered, went to hospital in Texas when she felt short of breath the next day.
A series of tests lead doctors to diagnose her with three separate conditions, which they believed could be linked to her overzealous cheering.
Her story recently appeared as a case study in the Journal of Emergency Medicine.
The doctors noted that while the girl was breathing quickly, her breathing sounded normal.
However, they noticed signs of crepitus - a cracking or clicking sensation that occurs under the skin - when they pressed down around her neck and chest.
Speaking to Live Science, report author Dr J. Mack Slaughter Jr. described the sensation as “feeling Rice Krispies”.
Following x-rays the doctors diagnosed the girl with pneumothorax, which is the term given when air builds up between the outside of your lung and the inside of your ribcage. This is also known as a collapsed lung.
After further examination she was also diagnosed with pneumomediastinum, which is when abnormal gas or air is contained within the mediastinum (the space in the chest between the lung sacs).
Finally, doctors identified rogue air in a third place, near the back of the throat, and diagnosed her with pneumoretropharyngeum.
The team said there was no evidence to suggest an underlying lung condition caused the three problems and noted that shouting could have prompted the damage, although this was impossible to conclude for certain.
“Spontaneous pneumothorax, pneumomediastinum, and pneumoretropharyngeum are uncommon diagnoses individually, and furthermore, the combination of all three diagnoses has yet to be described in medical literature,” they said in the report.
Commenting on the case study, GP Dr Clare Morrison, from online doctor service MedExpress, said it’s important to remember the girl’s experience is extremely rare.
“I cannot think of another time when lungs have collapsed due to screaming at a pop concert - but there’s a first time for everything,” she told HuffPost UK.
“So it’s important not to panic and for parents to get too judicious.”
She said smokers and recreational drug users have a higher chance of a pneumothorax - or lung collapse - than the general popualation.
“Also, if you’re suffering from a condition like asthma or pneumonia, your chances increase,” she added.
She pointed out that symptoms of a collapsed lung include:
Chest tightness
Tiredness
Rapid heart rate
Nasal flaring
Blue-coloured skin
“A small pneumothorax will likely go away on its own - you could only need oxygen treatment and rest,” Dr Morrison added.
“Often a needle will be used to pull the air out from around the lung so it can expand fully. If the pneumothorax is large, a chest tube will be placed between the ribs into the space around the lungs to help with draining the air and allow the lung to re-expand.
“In such an instance, you could need to stay in hospital. In some more extreme cases, patients may need lung surgery.”