<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-2024-554
Date of Submission: 2024-10-28

This report was submitted by a Pharmacist from Lopez Inc Medical Center concerning patient ANON-PX-3532. The subject is a 87-year-old male with a significant medical history including seasonal allergies, migraines, type 2 diabetes. 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 Oral route at a dosage of 135mg, initiated on 2024-08-01 for Bacterial infection with the course ongoing.

On approximately 2024-08-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Stevens-Johnson syndrome, Dizziness, Pruritus. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed range and advised physical. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed reason and advised blue. The current patient status regarding this symptom is '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. 

Reporter's Narrative Summary: Challenge growth floor four public happy western. Suffer beautiful ever cold several note.</data>
report_id: ADR-2024-554
report_date: '2024-10-28'
patient_details:
  patient_id: ANON-PX-3532
  gender: Male
  relevant_history:
  - seasonal allergies
  - migraines
  - type 2 diabetes
  age_at_reaction: 87
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 135mg
  route_of_administration: Oral
  start_date: '2024-08-01'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-08-12'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-12'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed range and advised physical.
- symptom_name: Dizziness
  onset_date: '2024-08-12'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2024-08-12'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed reason and advised blue.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Lopez Inc Medical Center
reporter_type: Pharmacist
notes: Challenge growth floor four public happy western. Suffer beautiful ever cold
  several note.
