Capturing zebras: what to do with a reportable case

We had attempted to publish a report of an unusual manifestation of an uncommon disease discovered at autopsy. The case report was not accepted for publication because we had failed to order a highly specific test that would have unequivocally confirmed the diagnosis we entertained and subsequently wrote about. After much deliberation about this case and an extensive review of the literature, we now believe that there is a preferred approach to dealing with a reportable case. Because physicians seldom encounter cases that are reportable, we felt that sharing the important lessons we learned from our missed opportunity might prove helpful and encourage those who are considering preparing a case report for publication.

本团队曾尝试发表一篇关于尸检中发现的罕见疾病非典型表现的病例报告。该稿件未获期刊录用，缘由为我们未开展一项高特异性检测，而该检测本可明确证实我们当时考量并随后在文中阐述的诊断结论。经对该病例的充分研讨及对相关文献的全面回溯后，我们如今认为，处理可投稿病例存在更优路径。鉴于临床医师极少接触可投稿发表的病例，我们认为分享此次错失契机中汲取的宝贵经验，或可为有意撰写病例报告并投稿的同仁提供参考与激励。