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What Killed the Patient—the Disease or the Experimental Treatment?

Arch Intern Med. 2000;160:2253-2254.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A 38-YEAR-OLD woman underwent excision of a nodular malignant melanoma of the right scapular region (level III; Breslow depth, 1.6 mm). Right axillary lymph node dissection a month later showed metastases in 5 of 6 nodes—3 with extracapsular spread. Six months later, the patient had a dental abscess associated with a dental implant; the abscess was treated with removal of the implant and 6 days of antibiotic therapy with metronidazole and amoxicillin. The next day, the patient got a new pet dog; she already had cats. The day after acquiring the dog, the patient was enrolled in a ganglioside adjuvant vaccine study (for treatment of melanoma) and received her first dose.^1-2 After receiving the vaccine, the patient developed progressive dyspnea. At first she had dyspnea only after she walked up a flight of 8 stairs, but it worsened until it occurred after only minimal effort such as blow-drying her hair.

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AUTOPSY FINDINGS

COMMENT



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