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The value of reporting cases

Journal of Community Hospital Internal Medicine Perspectives
Informa UK (Taylor & Francis)
Publication Date
DOI: 10.3402/jchimp.v1i4.15884
  • Editor'S Perspectives
  • Communication
  • Medicine


doi:10.3402/jchimp.v1i4.15884 The value of reporting cases W hen I wrote my first case report and it was published in a premiere medical journal (1), I was thrilled. The acceptance meant the world to me. It was a remarkable case with a unique combi- nation of coexisting problems. Most importantly, we thought it was a one-of-a-kind case of cryptococcal infection emerging in a Cushingoid patient who had become adrenally excessive by virtue of an ACTH- secreting lung cancer. We thought it was the first case of disseminated cryptococcosis secondary to endogenous steroid excess. Previously, cryptococcal infections second- ary to Cushing’s syndrome had been associated with exogenous steroids. Four months later, a letter to the editor in the same journal (2) pointed out that our literature review had missed a previous similar case published in the New England Journal of Medicine in 1959 (3). The respondent closed with ‘Does it matter who is first?’ Many years later (and hopefully wiser), I should not have been crushed. Uniqueness is nice in case reports but not essential. What is essential is the case report exercise itself. The process requires examination of details, careful documentation and recording, and communication. It requires an understanding of the appropriate literature. Even if the case is not unique, it may be the exception that proves the rule. What makes a case publishable? It is publishable if, after introducing the reader to what lies ahead, the reader is interested in reading on to learn. The case report should be contributory to the knowledge of readers. It enlightens them and makes them think about their own experiences. In 1930, Fuller Albright and others reported the case of Dr. Charles Martel, a sea captain who later developed osteitis fibrosis cystica from one of the first diagnoses of hyperparathyroidism secondary to a parathyroid adenoma (4). The images depicted in the journal stuck with me when I first

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