ArticleJournal of the American College of Emergency Physicians open2024
Opioid-related xylazine toxicity manifesting as myonecrosis, rhabdomyolysis, multifocal ischemic cerebral infarcts, and cerebral edema.
Article in Journal of the American College of Emergency Physicians open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmacogenetic Evidence in Opioid-Related Toxicity and Death with an Appraisal of Emerging Multi-Omics Studies: A Systematic Review.International journal of molecular sciences · 2026Pooled it
- Management of xylazine toxicity, overdose, dependence, and withdrawal: A systematic review.The American journal on addictions · 2025Pooled it
- New trends in the overdose epidemic: postural impact on abusers of fentanyl and xylazine and clinical and forensic implications.Forensic science, medicine, and pathology · 2026Review
- Adverse maternal and neonatal effects associated with perinatal xylazine exposure: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Comparative Pharmacokinetics of Intranasal or Intramuscular Atipamezole in Unsedated Dogs and Efficacy for Reversal of Xylazine Sedation.Journal of veterinary pharmacology and therapeutics · 2026Article
- No evidence for xylazine causing cerebral infarcts.Journal of the American College of Emergency Physicians open · 2024Article
- Letter to the Editor-Response to "Opioid-related xylazine toxicity manifesting as myonecrosis, rhabdomyolysis, multifocal ischemic cerebral infarcts, and cerebral edema".Journal of the American College of Emergency Physicians open · 2024Article
- Opioid-related xylazine toxicity manifesting as myonecrosis, rhabdomyolysis, multifocal ischemic cerebral infarcts, and cerebral edema.Journal of the American College of Emergency Physicians open · 2024Article
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Authors and funding
10 authors.
Funding
Abstract
This article provides a report of a case of organ dysfunction, myonecrosis, rhabdomyolysis, multifocal ischemic cerebral infarcts, and cerebral edema after a patient's use of xylazine and fentanyl. Within the US opioid epidemic, xylazine is emerging as a troubling national sub-story. The prevalence of xylazine within illicitly manufactured opioids and the proportion of opioid-involved overdose deaths with detected xylazine are rising dramatically, the latter increasing 276% between 2019 and 2022. A 27-year-old woman with opioid use disorder, active intravenous drug use, and prior bacteremia presented to our institution's emergency department (ED) with left lower extremity pain and associated weakness, new acute bilateral hearing loss, multiple electrolyte derangements, and cerebral infarcts followed by cerebral edema, leading to an emergent sub-occipital decompressive craniectomy and placement of an external ventricular drain. A definitive mechanism was not determined; however, we hypothesized that xylazine toxicity played a role in her clinical presentation, which could have future clinical implications, including the possibility to incorporate xylazine as part of toxicology screens.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.