When Encountering a Rare Vascular Disease, Report and Share your Experience: Six Reasons to Publish a Case Report in VSI.

Abstract

Approximately 20 years ago, when I started my career as a vascular surgeon after fellowship training, I received an emergency call for a 52-year-old female with flu-like symptoms, fever, and painful swelling of her left neck and arm for 8 days. She had no history of trauma or central catheterization. Contrast-enhanced computed tomography revealed extensive acute thrombosis in the left internal jugular and subclavian veins. I had never seen such extensive venous thrombosis before. No one around me knew about this disease. I searched vascular textbooks; however, none were helpful. I proceeded to search the PubMed database using the search terms “thrombosis subclavian vein internal jugular vein.” It revealed more than 200 articles, the abstracts of which I read, concentrating on and searching for answers regarding diagnosis and treatment. Finally, I found an article dealing with Lemierre syndrome that exactly matched the clinical presentation of my patient. It took about 2 hours, and I left work with a happy heart after ordering antibiotics and anticoagulants. The following day, I attempted a more aggressive treatment approach via aspiration thrombectomy to obtain samples of infected thrombi for microbiological culture and to decrease the thrombus burden for earlier recanalization. However, the thrombi were thick and adhered to the vessel wall due to inflammation, and the retrieved thrombi revealed no microorganisms. After 6 weeks of antibiotics and 3 months of anticoagulant therapy, the veins completely recanalized, and her symptoms disappeared. Later, I realized that thrombolysis could be dangerous, causing multiple septic emboli, pneumonia, or systemic abscesses. After experiencing this rare case, I published a case report to share my knowledge [1]. This case report has been cited by at least 6 doctors and has helped more patients. Herein, I would like to summarize why case reports of rare vascular diseases are needed, and how to write a good case report.