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CMAJ • August 22, 2000; 163 (4)
© 2000 Canadian Medical Association or its licensors

Review
Synthèse

Capturing zebras: what to do with a reportable case

Scott M. Wright and Chrisostomos Kouroukis

Dr. Wright is with the Division of General Internal Medicine, Johns Hopkins Bayview Medical Center and the Johns Hopkins University School of Medicine, Baltimore, Md. Dr. Kouroukis is with the Division of Hematology, Department of Medicine, McMaster University, Hamilton, Ont.

Abstract

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.