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Doctor usually uses his experience from the clinical practice to confirm a diagnosis and to prescribe an appropriate treatment for a specific patient. The computerized medical reasoning should not only focus on existing medical knowledge but also on physician's previous experiences and new knowledge. Such knowledge and experience are vague and define uncertain relationships between facts and diagnosis. Case Based Fuzzy Cognitive Maps (CBFCM) are proposed as an evolution of Fuzzy Cognitive Maps (FCM) that allow more complete representation of knowledge since case-based fuzzy rules are introduced to improve FCM decision support systems. Semantic web is used to implement both FCM approaches. A database of 71 patients with urinary tract infections was used to perform the proposed approach. A comparative study between FCM (92%) and CBFCM (99%) was conducted and the results derived by CBFCM approach showed CBFCM to be superior to FCM.