<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-2024-827
Date of Submission: 2024-10-29

This report was submitted by a Other Healthcare Professional from Ford-Johnson Medical Center concerning patient ANON-PX-5956. The subject is a 20-year-old female with a significant medical history including type 2 diabetes, chronic kidney disease. 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 administered via the Subcutaneous route at a dosage of 230mg, initiated on 2024-09-12 for Bacterial infection and discontinued on 2024-10-22; Lisinopril administered via the Topical route at a dosage of 251mg, initiated on 2024-09-12 for Hypertension and discontinued on 2024-10-22.

On approximately 2024-10-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Headache. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed usually and advised task. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed their and advised region. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-827
report_date: '2024-10-29'
patient_details:
  patient_id: ANON-PX-5956
  gender: Female
  relevant_history:
  - type 2 diabetes
  - chronic kidney disease
  age_at_reaction: 20
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 230mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-12'
  indication_for_use: Bacterial infection
  end_date: '2024-10-22'
- drug_name: Lisinopril
  dosage: 251mg
  route_of_administration: Topical
  start_date: '2024-09-12'
  indication_for_use: Hypertension
  end_date: '2024-10-22'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-10-18'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed usually and advised task.
- symptom_name: Headache
  onset_date: '2024-10-18'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed their and advised region.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Ford-Johnson Medical Center
reporter_type: Other Healthcare Professional
