A case for case reports—And a new publishing platform for clinical mycology

Dear Readers and Authors,

For a scientific journal aiming for a top ranking in the Journal Citation Reports or similar databases case reports are often less than welcome. Even if they have a “high impact” – meaning that clinicians read them and adjust their actual case management according to what they learned – they will not necessarily get cited. This is because they are by their very nature, based on the experience in treating a single patient or a limited number of patients. Consequently, case reports have been counted among the items that negatively afflict a journals impact factor as they receive “only negligible citations” [5,4]. This was not without consequences and journals have often tried to get rid of the “case report burden” or at least have not provided encouraging noises. As an example for this Mycoses, one of the major journals in medical mycology, states that “Case Reports may be submitted but only those which are RARE or of EXCEPTIONAL INTEREST will be considered” in its instructions to authors (Mycoses, Instructions for Authors). Other journals completely removed case reports from their portfolio [6].

However, despite this case reports of general published descriptions of clinical observations still have an important role in clinical medicine, and in the field of infectious diseases [1]. The thorough examination of histological specimens from gastritis patients that led to the discovery of Helicobacter pylori later awarded with a Nobel prize may serve as an example [7]. Another example was the accumulating reports on Pneumocystis pneumonia and other opportunistic infections in the early 80's which ultimately resulted in the discovery of HIV ([3] and many other reports) and thus again in Nobel prize winning research. As a “literal equivalent of bedside teaching” [2] case reports have contributed and perhaps formed a basis for many important clinical developments in the past. There is no reason to suspect that they will not do so in future. Indeed, we strongly feel that the first reports accepted by Medical Mycology Case Reports (MMCR) provide further evidence for this in highlighting a potential novel clinical entity in allergic diseases related to fungi (Singh et al., 2012), pointing towards a potential association between chronic fungal infection and neoplasm (Delsing et al., 2012) or proposing new possible routes of dissemination for fungal pathogens (Camargo et al., 2012).

Each year more than 300 case reports on fungal infections or fungus associated diseases are published. These reports are spread over a large number of journals and even this will be under representative of the number of potential case reports in our field. The top 3 journals (among them our sister journal Medical Mycology) cover only 14% of these reports whereas the others are distributed over 193 different other journals. This broad and thin coverage can make these reports largely inaccessible from many places. In launching MMCR, the International Society for Human and Animal Mycology (ISHAM) opens an entirely new format for publishing and accessing case reports related to fungal infection (or indeed any kind of fungus-related pathology in humans and animal). One of the major aims of ISHAM is “to facilitate on an international basis the exchange of ideas and information and provide assistance pertaining to medical and veterinary mycology” (www.ISHAM.org). Our new platform will be open access, fully indexed and embedded with the most sophisticated search facilities available. More than this, MMCR was also designed to be easy-to-work-with and fast! ISHAM and Elsevier have put considerable thought into this: a case report template is provided by the journal, which makes it extremely easy to submit manuscripts. Reviewing of case reports will be performed within 21 day (and indeed we have been considerably faster until now in most cases), and there are clear cut rules and guidance for reviewers which are accessible for all authors on our homepage. The review process does not allow for “major revisions” (which have been considered the blight of modern science in general) and will generally result in “accept” (so far for most submissions) or “reject” decision only. MMCR also requests a standardized way of presenting cases and makes a clear time-line with a defined day 0 and all other time-points given in relation to this day 0 mandatory for each case report.

These regulations are an attempt to not only provide a platform for case reports but also to enhance their value for the community. In the future we will be able to publish collections of specific case reports to illustrate emerging trends and themes for research and educational purposes. Those organisation who would be interested in sponsoring such a collection of reports are very welcome to suggest this to the editor in chief. All these features of MMCR provide a clear rationale to make our new journal a “home” for fungal case reports, and for this reason our sister journal Medical Mycology has stopped publishing case reports since the launch of MMCR. However, we are actively aiming at further improvements and this can most efficiently be achieved in a lively exchange with authors and readers. Therefore we invite you not only to publish your case reports in MMCR or to browse our contents but also to get back to us with your thoughts and opinions whenever you wish. In the end, it is going to be the challenge of each member of the world-wide community of clinicians, microbiologists and scientists interested in medical and veterinary mycology to make MMCR successful.

We invite all of you to join us in this!