<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-2025-431
Date of Submission: 2025-02-24

This report was submitted by a Physician from Sherman Ltd Medical Center concerning patient ANON-PX-4171. The subject is a 77-year-old other with a significant medical history including chronic kidney disease, type 2 diabetes, asthma. 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 452mg, initiated on 2025-01-18 for Bacterial infection and discontinued on 2025-02-18; Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 214mg, initiated on 2025-01-18 for Hypertension and discontinued on 2025-02-18.

On approximately 2025-02-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Nausea, Angioedema, Pruritus. The Maculopapular Rash was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Angioedema was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed product and advised fish. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-431
report_date: '2025-02-24'
patient_details:
  patient_id: ANON-PX-4171
  gender: Other
  relevant_history:
  - chronic kidney disease
  - type 2 diabetes
  - asthma
  age_at_reaction: 77
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 452mg
  route_of_administration: Intramuscular
  start_date: '2025-01-18'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-02-18'
- drug_name: Lisinopril
  dosage: 214mg
  route_of_administration: Intravenous
  start_date: '2025-01-18'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-18'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-02-13'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-02-13'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-02-13'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-02-13'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed product and advised fish.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Sherman Ltd Medical Center
reporter_type: Physician
