<format type="yaml">{report_id: string, report_date: date, patient_details: {patient_id: string, age_at_reaction: number optional, gender: string, relevant_history: list[string]}, suspected_drugs: list[{drug_name: string, drug_class: string optional, dosage: string, route_of_administration: string, start_date: date, end_date: date optional, indication_for_use: string}], adverse_reactions: list[{symptom_name: string, onset_date: date, severity: string, outcome: string, intervention_required: boolean, intervention_details: string optional}], causality_assessment: {naranjo_score: number optional, assessment_conclusion: string, dechallenge_rechallenge: string}, reporting_facility: string, reporter_type: string, notes: string optional}</format> <data>PHARMACOVIGILANCE CASE REPORT - CONFIDENTIAL
Report Identifier: ADR-2025-764
Date of Submission: 2025-05-28

This report was submitted by a Pharmacist from Hicks Inc Medical Center concerning patient ANON-PX-9201. The subject is a 62-year-old female with a significant medical history including type 2 diabetes, migraines. The facility's standard operating procedure for ADR reporting was followed, and all patient data has been anonymized. The patient chart was reviewed for comorbidities. 

Current medication review revealed the following suspected agent(s): Amoxicillin (Penicillin antibiotic) administered via the Intramuscular route at a dosage of 285mg, initiated on 2025-03-16 for Bacterial infection with the course ongoing.

On approximately 2025-05-19, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Headache, Pruritus. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed film and advised respond. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed summer and advised as. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-764
report_date: '2025-05-28'
patient_details:
  patient_id: ANON-PX-9201
  gender: Female
  relevant_history:
  - type 2 diabetes
  - migraines
  age_at_reaction: 62
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 285mg
  route_of_administration: Intramuscular
  start_date: '2025-03-16'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-05-19'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed film and advised respond.
- symptom_name: Headache
  onset_date: '2025-05-19'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed summer and advised as.
- symptom_name: Pruritus
  onset_date: '2025-05-19'
  severity: Severe
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 6
reporting_facility: Hicks Inc Medical Center
reporter_type: Pharmacist
