How to write and publish a medical case report

Step 1: Decide whether the case is worth publishing

Journals receive many case reports and usually favour those with a clear learning point. Before you write, search PubMed and other databases for similar cases. Ask yourself:

• Is the presentation, diagnosis or outcome genuinely unusual, or does it show a common condition in an instructive way?
• Does it describe an unexpected drug effect, interaction or complication?
• Would it change how another clinician thinks or acts?
• Do you have the data to support it: images, laboratory results, follow-up?

Step 2: Get consent and protect privacy first

Do this before you write. For the wider rules on reporting approval and consent, see ethics approval and consent statements. The ICMJE Recommendations say patients have a right to privacy that should not be violated without informed consent. In summary:

• Do not publish names, initials, hospital numbers or other identifying information unless it is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication.
• Informed consent for this purpose requires that the identifiable patient is shown the manuscript to be published.
• Omit non-essential identifying details. If there is any doubt that anonymity can be maintained, obtain consent. ICMJE notes that masking the eye region in photographs is inadequate protection.
• Consent should be written and archived, as local regulations require. Many journals have their own consent form, so check the author instructions.

Also check your hospital's or university's ethics committee policy. Some institutions require approval or a formal waiver for case reports; others do not. Remove names, dates and hospital details from images, including those embedded in scan files.

Step 3: Structure the report with the CARE checklist

The CARE guidelines (CAse REport) are the reporting guideline for case reports, listed by the EQUATOR Network. The 2013 CARE checklist has 13 items. In plain terms:

Many journals ask you to upload a completed CARE checklist with your submission.

Step 4: Write clearly

Case reports are usually short, with few figures and a short reference list, but each journal sets its own word and reference limits. Tips, especially if English is not your first language:

• Use the past tense for what happened to the patient and the present tense for established knowledge.
• Use generic drug names, standard units and define every abbreviation the first time you use it.
• Keep the discussion focused on the learning point. A long literature review is a common reason editors ask for cuts.
• Do not overstate. One case shows that something can happen, not how often it happens.
• Check that dates, ages and values match across the text, timeline and tables.

Step 5: Agree authorship and disclosures

The ICMJE recommends that authorship be based on the following 4 criteria:

1. Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND
2. Drafting the work or reviewing it critically for important intellectual content; AND
3. Final approval of the version to be published; AND
4. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Discuss this early between residents, consultants and other team members. ICMJE notes that writing assistance, technical editing, language editing and proofreading alone do not qualify for authorship; such help can be acknowledged. If you use AI tools for writing help, ICMJE asks authors to disclose this, and AI tools cannot be listed as authors.

Step 6: Choose the right journal

• Check that the journal publishes case reports. Many journals do not, and some accept them only in specific formats such as images or letters.
• Consider specialty journals and dedicated case-report journals. Read a few recently published case reports to judge the fit.
• Check indexing properly. "In PubMed" is not the same as "indexed for MEDLINE": MEDLINE is the largest component of PubMed, but PubMed also includes citations for PubMed Central articles and Bookshelf books (About PubMed). Check MEDLINE status in the NLM Catalog and Scopus or Web of Science status with our indexing guide. Our guide to PubMed-indexed journals explains each step.
• Check the fees. Many case-report journals are open access and charge an article processing charge. Confirm the fee on the publisher's site before submitting.
• Watch for predatory journals that send invitations to clinicians. Use the Think. Check. Submit. checklist.

Step 7: Submit and respond to reviewers

Your submission usually includes the manuscript, figures, the CARE checklist, a consent statement (and sometimes the signed form), conflict-of-interest disclosures and a short cover letter explaining what is new and why readers of that journal will benefit. If reviewers ask for changes, answer every comment point by point and show where you changed the text. If it is rejected, use the feedback, reformat for the next journal and resubmit.

How we can help

Our medical manuscript editing service supports doctors and residents with case reports: English editing, a CARE checklist review, a check that consent and ethics statements are present, formatting to the journal's instructions and a shortlist of verified journals through our journal submission support. We give no medical advice, we do not change your data or findings, and the authors remain responsible for all clinical content. You remain the author, and the journal decides on acceptance. We cover most medical and health specialties. Clinicians in the Gulf and Jordan can also see our pages for Saudi Arabia and the GCC and Jordan.

Independence: On Time Publication is not affiliated with Elsevier/Scopus, Clarivate/Web of Science, COPE, the ICMJE or any journal. We link to their public guidance so you can check it yourself.

Sources and further reading

We link to official sources so you can check the rules yourself. Always follow your target journal's and institution's current instructions.

• CARE Case Report Guidelines
• 2013 CARE Checklist
• EQUATOR Network: CARE guideline record
• ICMJE Recommendations
• ICMJE: Protection of research participants (patient consent)
• ICMJE: Defining the role of authors and contributors
• About PubMed: MEDLINE, PubMed Central and Bookshelf (US National Library of Medicine)
• NLM Catalog: journals referenced in the NCBI databases
• Think. Check. Submit. journal checklist