Selecting a Topic for a Case Report that you can be definite about

Do you want to make sure your Case Report is accepted, but not sure where to start? Then simply follow this guide. The guide contains personalized examples that’ll help shape the final production of what is, for many, their first publication.

For instance, with metformin, I saw that the risk of hypoglycemia is low, but viewing it from a different perspective, could the likelihood actually be lower with a particular dosage form and higher with another form? https://www.cureus.com/articles/62816-reactive-hypoglycemia-from-metformin-immediate-release-monotherapy-resolved-by-a-switch-to-metformin-extended-release-conceptualizing-their-concentration-time-curves
Takeaway
Always include follow-up data where you can; it gives a clear understanding of the outcome. The follow-up period should be defined.

Another case report gave me a rough time. Firstly, tuberculosis-induced bronchiectasis has a high prevalence. A senior associate in my institute of pathology actually laughed it out saying they’ve encountered renal amyloidosis as a sequelae of TB so many times it was worth publishing in a local journal only. But I went ahead with it considering I’d already collected the images and I was only a beginner-level physician, this was the first time I had seen a case like that. The good thing with Cureus is that it gives authors leverage. What is routine business for some may be new for others. So they went ahead and published it. https://www.cureus.com/articles/45499-tuberculosis-induced-bronchiectasis-complicated-by-recurrent-respiratory-tract-infections-and-renal-amyloidosis-a-classic-revisited
Takeaway
Why you think this case is important –
-TB is a prevalent health problem, hence you write it up.
-Is there a clear message?

A case report I worked on recently: Cerebral salt wasting (CSW) in a patient with TB. I ran a literature search and came across 2 or 3 case reports on the topic. So it’s always good to build on such a topic where there’s limited availability. It is unlikely a topic has not even slightly been touched upon before. https://www.cureus.com/articles/76913-cerebral-salt-wasting-syndrome-in-a-patient-with-active-pulmonary-tuberculosis
Takeaway
First, healthcare workers including med students and junior doctors must find the cases a valuable learning resource, both relevant and engaging.
Second, there is more to learn from common cases that present in an unusual way, present a diagnostic, ethical or management challenge or where there are pitfalls to learn from, than from rare or exotic cases that most of us are unlikely ever to have to manage.
Another takeaway
For example: In patients with neurologic disease, the chief difficulty in discerning the cause of hyponatremia and its subsequent treatment lies in distinguishing CSW from the more familiar syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Particular historical details and investigations separate these diagnoses, and treatment of each is vastly different; indeed, treating one cause for the other is detrimental. Discuss these and the pitfalls that may ensue.
A case report illustrates this dilemma in the clinical sitting. A 43-year-old man with an intracranial insult was initially misdiagnosed as SIADH based on the common features that characterize both syndromes - hyponatremia, decreased serum osmolality, and urine osmolality > 100 mOsm/kg. However, the fact that urine output remained high and sodium levels continued to decline despite fluid restriction led to the consideration of another diagnosis. When treated accordingly with isotonic saline, sodium levels gradually improved, thus allowing a diagnosis of probable CSW. He was discharged with normalized sodium levels. Ref: Momi J, Tang CM, Abcar AC, Kujubu DA, Sim JJ. Hyponatremia-what is cerebral salt wasting?. Perm J. 2010;14(2):62-65.

Ending hint is that coronaviruses and pox viruses are on the rise in market. There are millions of ways they can be utilized in building a case report. Utilize it! To be honest, I saw nothing new in a case except ‘in the setting of Covid-19’. And it worked! That being said, try working with fellows and attendings, it’ll make publication a definite.

So, go ahead and start typing. I look forward to seeing your work.