<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-2025-693
Date of Submission: 2025-06-27

This report was submitted by a Other Healthcare Professional from Brown Inc Medical Center concerning patient ANON-PX-1786. The subject is a 59-year-old female with a significant medical history including anxiety, coronary artery 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 (Penicillin antibiotic) administered via the Intravenous route at a dosage of 271mg, initiated on 2025-04-14 for Bacterial infection and discontinued on 2025-06-23; Ibuprofen (NSAID) administered via the Topical route at a dosage of 167mg, initiated on 2025-04-14 for Pain and inflammation and discontinued on 2025-06-23.

On approximately 2025-06-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Maculopapular Rash, Pruritus, Anaphylaxis. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed end and advised analysis. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed another and advised baby. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-693
report_date: '2025-06-27'
patient_details:
  patient_id: ANON-PX-1786
  gender: Female
  relevant_history:
  - anxiety
  - coronary artery disease
  age_at_reaction: 59
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 271mg
  route_of_administration: Intravenous
  start_date: '2025-04-14'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-06-23'
- drug_name: Ibuprofen
  dosage: 167mg
  route_of_administration: Topical
  start_date: '2025-04-14'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-06-23'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-06'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed end and advised analysis.
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-06'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-06-06'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-06-06'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed another and advised baby.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 2
reporting_facility: Brown Inc Medical Center
reporter_type: Other Healthcare Professional
