Targeted literature searches are a fundamental part of writing clinical manuscripts that will meet the standards of high-quality journals and contribute meaningfully to evidence-based practice. When physicians write clinical manuscripts, utilizing a targeted literature search can identify high-quality, relevant, and current evidence. While a general literature review is useful, a targeted literature search is specific to the clinical question and should be completed through frameworks established, such as PICO (Population, Intervention, Comparator, Outcome) and PRISMA [1].

How to Handle Rejected Case Reports: Revising for a New Journal

Revising for a New Journal

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How to Handle Rejected Case Reports: Revising for a New Journal

Table of Content
1. Introduction: Rejection as a Stepping Stone
2. Step 1: Understanding the Reasons for Rejection
3. Step 2: Select a New Target Journal Strategically
4. Step 3: Reformat and Revise Structure
5. Step 4: Strengthen the Discussion Section
6. Step 5: Address Ethical and Legal Gaps
7. Step 6: Update the Literature Review
8. Step 7: Revise Title and Abstract
9. Step 8: Write a New Cover Letter
10. Step 9: Resubmit and Prepare for Peer Review Again
11. Conclusion
12. References

Introduction: Rejection as a Stepping Stone

Rejection is common, and sometimes disheartening, in academic publishing, especially in the context of case reports. However, a rejection does not signify the end of the road. Authors can always use the feedback from reviewers and editorial comments to revise and submit to a more appropriate journal [1]. This article will provide a step-by-step plan for revising rejected clinical case reports for submission to another journal.

Step 1: Understanding the Reasons for Rejection

Journals reject case reports for a variety of reasons. It is important to categorize these reasons to help format revisions [2]:

Common Reasons for Case Report Rejection

Category	Specific Issues
Scope mismatch	Topic irrelevant to journal aims
Methodological concerns	Inadequate patient information, missing diagnostic details
Ethical issues	No informed consent or IRB clearance
Redundancy	The case is not novel and has already been reported
Structural issues	Poor organization, formatting errors, and lack of references
Language and clarity	Grammatical errors, unclear writing

Example: A case report on a rare dermatological condition was rejected from a cardiology journal due to a scope mismatch.

Step 2: Select a New Target Journal Strategically

Choosing the next journal must be deliberate. Avoid resubmitting blindly.

Journal Selection Factors:

Relevance of the scope and audience
Acceptance of case reports (most journals explicitly reject case reports)
Word count limits, table/figure limits
Open access or subscription
Turnaround times and impact factor (if applicable)

Example Tools:

JANE (Journal Author Name Estimator) [3]
Elsevier Journal Finder [4]
Springer Journal Suggester

Case Example: A case on primary adrenal tuberculosis was rejected by a high-impact endocrinology journal but was accepted by a tropical medicine journal more aligned with infectious diseases.

Step 3: Reformat and Revise Structure

Each journal has different structural requirements. Once a new journal is selected, you have to modify the manuscript.

Elements to Re-customize:

Abstract format (structured vs unstructured)
Reference style (APA, AMA, Vancouver, etc.)
Level of headings and section titles
Word limits and number of figures/tables
Spelling (e.g., UK vs US English)

Sample Structural Differences

Section	Journal A Requirement	Journal B Requirement
Abstract	Structured (250 words max)	Unstructured (150 words max)
References	Vancouver style	APA 7th edition
Word Count	2000 words excluding references	1500 words including references
Images	Max 4, grayscale preferred	Max 6, colour allowed

Step 4: Strengthen the Discussion Section

This is often the weakest section in rejected manuscripts.

Customize Your Discussion by:

Highlighting the clinical implications clearly
Compared with recent case reports or cohort studies
Adding mechanistic insights or diagnostic reasoning
Identifying learning points explicitly

Step 5: Address Ethical and Legal Gaps

A frequent cause of desk rejection is missing patient consent or ethics statements.

Ensure:

Written informed consent is obtained and documented
A clear Ethics Statement is added if required
Patient identifiers are removed from all figures/images

Ethics Statement Template: Written informed consent was obtained from the patient for publication of this case and any accompanying images.

Step 6: Update the Literature Review

A part of customizing your manuscript entails strengthening its academic foundation.

Tips:

Use more recent citations (5 years < or unless foundational citations)
Include recent case reports that are relevant from the target journal
Search clinical databases (PubMed, Embase, Scopus)

Step 7: Revise Title and Abstract

The title should reflect the uniqueness of the case in line with the journal’s tone.

Title Customization:

Be specific and concise
Include disease, symptom, or intervention
Add “Case Report” if the journal permits

Title Example:

Before	After
A Rare Disease in a Young Woman	Case Report: A rare case of multicentric angiosarcomas of bone mimicking multiple myeloma on ¹⁸F-FDG PET/CT [5]

Abstract Customization:

Remove jargon
Include key findings, diagnosis, treatment, and outcome
Align with word count

Step 8: Write a New Cover Letter

Do not reuse the old cover letter. A customized letter enhances the credibility of your revised submission.

Include in the Cover Letter:

Case novelty
Journal fit
Confirmation of consent and ethical compliance
Statement of no previous submission to the journal

Step 9: Resubmit and Prepare for Peer Review Again

Once resubmitted:

Track submission status regularly
Prepare a point-by-point response if reviewers ask for further revision
Maintain a record of all journal submissions and decisions for compliance

Best Practice: Avoid submitting to multiple journals simultaneously unless permitted.

Connect with us to explore how we can support you in maintaining academic integrity and enhancing the visibility of your research across the world!

Conclusion

Rejection of a clinical case report does not indicate failure. By analysing feedback, choosing an appropriate journal, and customizing content accordingly, authors can significantly improve the chances of acceptance. Treat rejection as a revision roadmap, not dead-end.

Need help rewriting or formatting your rejected clinical case report? Our expert medical writing team at Pubrica can revise and align your manuscript for successful resubmission.

References

Schroter, S., Tite, L., & Smith, R. (2005). Perceptions of open access publishing: interviews with journal authors. BMJ (Clinical research ed.), 330(7494), 756. https://doi.org/10.1136/bmj.38359.695220.82
Shyam A. (2018). Common Causes of Rejection of Case Reports. Journal of Orthopaedic Case Reports, 8(4), 1–2. https://pmc.ncbi.nlm.nih.gov/articles/PMC6343572/
Journal / Author Name Estimator. (n.d.). Biosemantics.org. Retrieved June 28, 2025, from https://jane.biosemantics.org/
Journal finder. (n.d.). Elsevier.com. Retrieved June 28, 2025, from https://journalfinder.elsevier.com/
Huang, W., Xiao, X., Zhang, Y., Peng, Y., Song, L., Li, L., Gao, J., & Kang, L. (2023). Case Report: A rare case of multicentric angiosarcomas of bone mimicking multiple myeloma on 18F-FDG PET/CT. Frontiers in Medicine, 10, 1330341. https://doi.org/10.3389/fmed.2023.1330341