Maintain patient confidentiality . Take precautions to protect the anonymity of the patient described in the case report. For example, delete the patient's initials, mask his or her eyes in photographs and remove telling details from the history. The International Committee of Medical Journal Editors urges authors to omit identifying details if they are not essential but to avoid altering or falsifying information to attain anonymity. Because the masking manoeuvres sometimes fail, it is crucial to obtain informed consent.
Consultants can be helpful in rare, unusual cases.
Not only might they be able to add to the literature search in helping to determine whether the case in question is reportable, they might also be able to provide suggestions for the work-up and patient management. One should not simply consult whoever is on service for the month. Instead, ask for input from the specialist in the hospital division with the most knowledge and interest in the disease in question. Likewise, it may be necessary to obtain a second opinion for any pathological specimen or to seek a pathologist with a special interest in the topic area. Request an autopsy .