Some of the most-read papers in medicine are single-patient case reports: the first description of a new syndrome, an unexpected drug reaction, a diagnosis that everyone else missed. A good case report is not a lesser form of research — it is how the field first learns that something is possible. This guide walks through deciding whether your case is worth writing up, structuring it with the internationally recognised CARE guidelines, and clearing the one hurdle that sinks more case reports than any other: consent.
Is your case actually worth reporting?
Before you write a word, ask what a reader will learn. Editors look for a clear "so what". Strong case reports usually offer at least one of the following:
- An unexpected presentation of a common disease, or a rare disease presenting in a new way.
- An unusual or previously unreported association between conditions, or between a treatment and an adverse effect.
- A diagnostic or therapeutic challenge that reveals a lesson others can apply.
- A rare condition where every documented case adds to a very small evidence base.
"Interesting to me" is not the same as "useful to the field". If a competent clinician would already have managed the case the same way, it probably is not a case report.
The CARE checklist
The CARE (CAse REport) guidelines are the accepted reporting standard for case reports, and many journals now ask you to submit a completed CARE checklist. At a minimum, make sure your manuscript covers:
- Title — states that it is a case report and names the phenomenon of interest.
- Key words — 2–5 terms including the diagnosis.
- Abstract — a short, structured summary: background, the case, and the take-home message.
- Introduction — why this case matters, in 1–2 paragraphs.
- Patient information — de-identified demographics, main symptoms, relevant history.
- Clinical findings and timeline — a clear chronological account (a timeline figure helps enormously).
- Diagnostic assessment, intervention, and follow-up/outcomes.
- Discussion — strengths and limitations, and how the case fits the literature.
- Patient perspective (where appropriate) and informed consent.
Structure it section by section
The Introduction should be short. Two or three sentences on the condition, one on why this case is notable, and stop.
The Case presentation is the heart of the paper. Tell it in the order events happened — presentation, examination, investigations, working diagnosis, treatment, response, follow-up. A reader should be able to follow the patient's journey without flipping back and forth. Resist the urge to include every lab value; include the ones that mattered to the decisions you made.
The Discussion is where weak case reports fall apart. Do not simply retell the case. Instead: compare your case with what has been reported before, explain what was genuinely new or difficult, be honest about limitations, and finish with a concrete lesson — what should a clinician do differently after reading this?
A useful test: if you deleted the Discussion and a reader still learned nothing they could act on, the case report is not finished.
Consent is not optional
This is one of the most common reasons case reports are delayed or rejected. You need written informed consent from the patient — or, if the patient lacks capacity or has died, from their legal representative or next of kin — for publication, not just for treatment. Consent is required even when the patient is not named, because the combination of details can still identify someone. Remove identifying details (dates, locations, rare co-occurring facts) wherever they are not clinically essential, and state clearly in the manuscript that consent was obtained.
Before you submit: a quick self-check
- Does the title say "case report" and name the finding?
- Is there a clear timeline a stranger could follow?
- Does the discussion say what to learn, not just what happened?
- Is written consent obtained and stated?
- Have you completed the CARE checklist your target journal asks for?
Get those five right and you have already cleared the bar that most rejected case reports fail. Choose a journal whose scope matches the specialty, follow its author guidelines for word and reference limits, and submit with the consent statement in place.