- Before anything, set the scene: Start with a concise, but vivid, description of the patient’s presenting symptoms and why they matter to the patient.
- Then, build suspense by adding to the evidence. You should be judicious in providing just enough information for readers to be engaged, but not so much that they lose the plot.
- Only then, once you have your reader hooked, should you reveal your differential diagnosis, thoughtfully, integrating pathophysiology and clinical presentation as much as possible.
- Finally, reflect on the ultimate outcome and how that reasoning process brought you to that outcome.
Combined with eye-catching figures, illustrations and tables, this narrative approach can make your case report engaging and allow the reader to learn actively rather than passively.
Support Your Observations with Literature
Going back to the metaphor of the metropolis of medical literature, it’s important to remember that case reports cannot stand alone. They exist within neighborhoods of other case reports and are dependent on other types of literature. Therefore, it shouldn’t be surprising that the best case reports contextualize novel findings within existing knowledge.
Toward that end, if you are writing a case report, make sure to conduct a very thorough literature search. Any editor worth their salt will be looking for the following within the discussion section: gaps in knowledge that the case addresses, distinctions between this case and prior reports, and limitations that prevent over-generalization. By grounding your report in evidence, you strengthen its impact and credibility.
Keep It Concise & Clear
The overriding challenge of writing a case report is that case reports are fairly short. Most journals have strict word limits (typically 1,000–1,500 words), so every sentence must serve a purpose. Use clear, direct language, avoid unnecessary jargon, and focus on the key takeaways. The CARE Guidelines and Checklist may provide authors some assistance in structuring their case reports.3
From a more literary standpoint, I would advocate that writers use the narrative principle of Chekhov’s gun. Named after the famed 19th century Russian playwright, the principle highlights the economization of details. According to Chekhov, “If in the first act you have hung a pistol on the wall, then in the following one it should be fired. Otherwise don’t put it there.” Within the context of case reports, keep the past medical history, medication lists and review of systems pertinent.
In addition to the words within the narrative, tables and figures can be powerful tools to convey information efficiently. If you have a histopathology slide or relevant radiograph, include it. Tables of differential diagnoses with rationales are often helpful to guide readers through walls of text. And some of the most readable case reports are those that use timelines and graphs to show connections between the various findings and the final diagnosis.
