<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-2025-910
Date of Submission: 2025-05-30

This report was submitted by a Pharmacist from Yang-Rice Medical Center concerning patient ANON-PX-5321. The subject is a 78-year-old other with a significant medical history including seasonal allergies, asthma, atrial fibrillation. 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 Intramuscular route at a dosage of 480mg, initiated on 2025-03-30 for Bacterial infection and discontinued on 2025-05-18.

On approximately 2025-04-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Stevens-Johnson syndrome, Anaphylaxis, Dizziness, Hepatotoxicity. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-910
report_date: '2025-05-30'
patient_details:
  patient_id: ANON-PX-5321
  gender: Other
  relevant_history:
  - seasonal allergies
  - asthma
  - atrial fibrillation
  age_at_reaction: 78
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 480mg
  route_of_administration: Intramuscular
  start_date: '2025-03-30'
  indication_for_use: Bacterial infection
  end_date: '2025-05-18'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-04-29'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-29'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-04-29'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-04-29'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-29'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 10
reporting_facility: Yang-Rice Medical Center
reporter_type: Pharmacist
