News of unusual or interesting cases spread throughout the hospital or clinic like a virus. Everyone wants to hear about the patient with the rare syndrome or unheard of side-effect. Such cases engender fear, excitement and trepidation in the treating team and the patient. Often such a case will generate the suggestion from a consultant to junior doctor: ‘You should write this up’. And yet the humble case report is considered a lowly ranked publication. Single case reports are rarely cited and do not contribute to the Impact Factor for the publishing journal. They are given the lowest level of evidence rating and many journals have abandoned publishing case reports.