<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-2025-959
Date of Submission: 2025-01-30

This report was submitted by a Physician from Larsen, Wallace and Cain Medical Center concerning patient ANON-PX-3995. The subject is a 29-year-old female with a significant medical history including anxiety, coronary artery disease, 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 Intramuscular route at a dosage of 30mg, initiated on 2024-12-08 for Bacterial infection with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 41mg, initiated on 2024-12-08 for Hypothyroidism with the course ongoing.

On approximately 2024-12-19, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Hepatotoxicity, Headache, Dizziness, Stevens-Johnson syndrome. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed ago and advised real. The current patient status regarding this symptom is 'Not Recovered'. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

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. 

Reporter's Narrative Summary: Type tell should four response. War I stuff certain little. Poor ten letter drive fund goal. Program appear dinner someone begin nation.</data>
report_id: ADR-2025-959
report_date: '2025-01-30'
patient_details:
  patient_id: ANON-PX-3995
  gender: Female
  relevant_history:
  - anxiety
  - coronary artery disease
  - type 2 diabetes
  age_at_reaction: 29
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 30mg
  route_of_administration: Intramuscular
  start_date: '2024-12-08'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
- drug_name: Levothyroxine
  dosage: 41mg
  route_of_administration: Topical
  start_date: '2024-12-08'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-12-19'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-19'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-12-19'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed ago and advised real.
- symptom_name: Dizziness
  onset_date: '2024-12-19'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-12-19'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Larsen, Wallace and Cain Medical Center
reporter_type: Physician
notes: Type tell should four response. War I stuff certain little. Poor ten letter
  drive fund goal. Program appear dinner someone begin nation.
