Here’s another analogy: A case report is like a cookbook recipe for a unique dish.

The Case Report as a Unique Recipe

Imagine you’re a chef (doctor) who has created a unique dish (treated an unusual medical case).
Writing a case report is like documenting your cooking process so others can learn from it.

1. Formulating a Clinical Question

o Analogy: A new ingredient arrives in your kitchen (a patient with unusual
symptoms). Your first step is to ask: "What can I make with this?"
o Medical Context: Similarly, you start by asking: "What is causing these
symptoms, and how can I manage it effectively?"

2. Conducting a Literature Search

o Analogy: You check cookbooks or online recipes to see if others have used this
ingredient before. Has anyone created a similar dish? What techniques did they
use?
o Medical Context: You search medical literature and databases for similar cases
to find out how others have diagnosed or treated such conditions.

3. Critical Appraisal of Literature

o Analogy: You review the recipes you find. Are they from credible chefs? Do the
ingredients match what you have? Are the techniques practical?
o Medical Context: You critically analyze the relevance and quality of the medical
studies or reports. For instance, you check if a treatment method for a rare disease
is evidence-based and applicable to your patient.

4. Applying Evidence to the Case

o Analogy: Based on what you learned, you create your unique dish. You adjust the
recipe, experiment with techniques, and tailor it to your available ingredients and
taste preferences.
o Medical Context: Using the knowledge from your literature search, you design a
treatment plan tailored to your patient’s unique condition, making adjustments as
needed.
 5. Documenting the Case
o Analogy: After perfecting your dish, you write down the recipe—ingredients,
steps, challenges, and tips—to share with other chefs so they can recreate or
improve upon it.
o Medical Context: In a case report, you document the patient’s history, diagnosis,
treatment, and outcome. You highlight key lessons, enabling other doctors to
recognize and treat similar cases in the future.

Why This Analogy Works

 Ingredients = Patient's Symptoms: The raw materials you start with.

 Cookbooks = Medical Literature: The source of ideas and techniques.
 Recipe = Case Report: The step-by-step guide you create for others to follow.
 Unique Dish = Unique Case: Just like no two dishes are exactly alike, every patient’s
case has its distinct elements.

A good case report, like a recipe, combines creativity, knowledge, and clear documentation to
benefit others!

What is a Case Report?

A case report is a detailed account of a single patient's clinical presentation, diagnosis, treatment,
and follow-up. It highlights unique, rare, or unusual aspects of a patient's condition and offers
insights that may not emerge from broader clinical studies. Case reports are often the first step in
identifying new diseases, adverse effects of treatments, or novel therapeutic approaches.

Purpose of a Case Report

1. Education: To share clinical experiences and insights that enhance medical knowledge.
2. Awareness: To highlight rare conditions or unexpected outcomes.
3. Research Catalyst: To generate hypotheses for larger-scale research.
4. Improvement: To help refine diagnosis, management, or therapeutic techniques.
5. Documentation: To record and preserve clinical observations for future reference.

How to Write a Case Report

1. Title
oBe concise and specific.
oInclude the main condition or intervention discussed in the report.
2. Abstract
 o Summarize the case in 200–300 words.
o Include the background, key findings, diagnosis, treatment, and significance.
3. Introduction
o Explain the relevance of the case.
o Highlight the rarity, uniqueness, or educational value.
o Include a brief literature review.
4. Case Description
o Patient Information: Age, gender, medical history, and presenting complaints.
o Clinical Findings: Examination results, lab tests, and imaging.
o Diagnosis: Process and confirmation.
o Treatment: Details of intervention or management.
o Follow-up: Patient's progress and outcomes over time.
5. Discussion
o Compare the case with existing literature.
o Highlight the unique aspects and lessons learned.
o Discuss limitations and unanswered questions.
6. Conclusion
o Summarize the key takeaways.
o Mention how this case contributes to clinical knowledge.
7. References
o Cite all sources used, including textbooks, journal articles, or guidelines.
8. Acknowledgments
o Acknowledge contributions from colleagues, mentors, or institutions.
9. Consent
o Obtain informed consent from the patient to publish their data.

The CARE (CAse REport) checklist is a guideline designed to ensure that case reports are complete,
transparent, and provide sufficient information for readers to evaluate their significance. It is widely
used in medical and healthcare literature.

CARE Checklist for Writing a Case Report

1. Title
The title should explicitly include the term "case report" and clearly describe the focus of
the case to inform readers about its content.
2. Abstract
The abstract should provide a concise, structured summary, including the introduction,
patient information, clinical findings, diagnostic assessment, treatment, outcomes, and
conclusion.
3. Keywords
Select two to five relevant keywords that reflect the main topics or themes of the case
report.
4. Introduction
Begin with an overview of the context or background of the case, explaining why the
case is significant or novel. State the objective of presenting the case report.
 5. Patient Information
Provide detailed patient demographics, including age, sex, and ethnicity. Include relevant
medical history, family history, psychosocial history, and any other pertinent details.
6. Clinical Findings
Describe the patient's presenting symptoms and the significant clinical findings observed
during the examination.
7. Timeline
Present a chronological timeline summarising key events, tests, treatments, and outcomes
to provide a clear sequence of the case.
8. Diagnostic Assessment
Explain the diagnostic process, including the tests and procedures performed. Mention
any differential diagnoses considered and the challenges or uncertainties encountered.
9. Therapeutic Interventions
Provide a detailed description of all interventions, including the rationale for their
selection, how they were administered, and the duration of treatment.
10. Follow-up and Outcomes
Summarise the patient’s clinical course, including the response to treatment, adherence to
recommendations, and any changes in symptoms. Include details of long-term follow-up,
if applicable.
11. Discussion
Discuss the findings in relation to existing literature, highlighting the case’s uniqueness
and significance. Address any limitations of the report and its generalisability.
12. Patient Perspective
If possible, include a brief description of the patient’s perspective on their condition,
treatment, and overall experience.
13. Informed Consent
Confirm that informed consent was obtained from the patient or their legal guardian,
allowing the case to be published.
14. References
Provide accurate citations for all sources of information or related literature mentioned in
the case report.
15. Conflicts of Interest and Funding
Disclose any conflicts of interest and funding sources relevant to the case.
16. Ethical Approval
Clearly state whether ethical approval was required for the case and whether it was
obtained.

Example of a Case Report

Title

"Unusual Presentation of Dengue Fever: A Case of Acute Myocarditis in a Young Male"

Abstract

We report a case of a 25-year-old male who presented with symptoms of fever, chest pain, and
shortness of breath. Initial investigations revealed dengue fever with associated acute
myocarditis, a rare complication of the disease. He was managed with supportive care and close
monitoring, leading to full recovery. This case highlights the need for vigilance regarding
atypical presentations of common diseases.

Introduction

Dengue fever is a common mosquito-borne viral infection, often presenting with fever, rash, and
thrombocytopenia. Rare complications like myocarditis are infrequently reported, but they can
significantly increase morbidity if unrecognized. We present a case that underscores the
importance of recognizing and managing this rare complication.

Case Description

Patient Information
Patient's age, gender, medical history, and presenting symptoms are included. (CARE guideline:
Patient Information)

A 25-year-old previously healthy male presented with a 5-day history of high-grade fever,
fatigue, and a 1-day history of chest pain and shortness of breath.

Clinical Findings
Detailed clinical observations and findings are provided. (CARE guideline: Clinical Findings)

Physical examination revealed a febrile patient with a heart rate of 110 bpm and blood pressure
of 100/70 mmHg. No significant findings were observed in the chest or abdominal examination.

Investigations
A chronological description of diagnostic tests and results is provided. (CARE guideline:
Diagnostic Assessment)

 Blood Tests:
o Platelets: 75,000/μL (low)
o Hematocrit: 45% (mildly elevated)
o Dengue NS1 antigen: Positive
o Troponin I: Elevated

 Electrocardiogram (ECG): Sinus tachycardia with ST-segment elevation in leads V4–

V6.
 Echocardiography: Mildly reduced left ventricular ejection fraction (50%).
Diagnosis
The process used to arrive at the diagnosis is detailed. (CARE guideline: Diagnosis)

The patient was diagnosed with dengue fever complicated by acute myocarditis.

Treatment
All therapeutic interventions, including medications and procedures, are described. (CARE
guideline: Therapeutic Interventions)

 Supportive Therapy: Intravenous fluids, antipyretics, and rest.

 Monitoring: Continuous cardiac monitoring in the intensive care unit.
 Recovery: Over 5 days, the patient’s symptoms resolved, and repeat echocardiography showed
normalized cardiac function.

Follow-Up
The patient’s progress after treatment is documented. (CARE guideline: Follow-Up and
Outcomes)

The patient was discharged with advice to avoid strenuous activity for 6 weeks and referred for
follow-up with a cardiologist.

Discussion

Comparison with existing literature is presented. (CARE guideline: Discussion)

Myocarditis is a rare complication of dengue fever, caused by direct viral invasion or an

immune-mediated response. It is crucial to differentiate it from other causes of chest pain like
myocardial infarction. Supportive care remains the cornerstone of management, as no specific
antiviral therapy exists for dengue. This case emphasizes the importance of considering rare
complications when managing febrile illnesses in endemic areas.

Conclusion

Summarizes the key findings and implications of the case. (CARE guideline: Conclusion)

Dengue fever, though common, can present with rare and potentially life-threatening
complications such as myocarditis. Clinicians should maintain a high index of suspicion to
ensure timely diagnosis and management.
References

All sources are cited as per CARE guidelines. (CARE guideline: References)

1. World Health Organization. Dengue Guidelines for Diagnosis, Treatment, Prevention, and
Control.
2. Smith J, et al. "Cardiac Complications in Dengue Fever: A Review." Journal of Tropical Diseases,
2020.

Patient Consent

Informed consent from the patient is included. (CARE guideline: Patient Perspective and
Consent)

Informed consent was obtained from the patient for publication of this case report.