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Pediatric xylazine toxicity following accidental veterinary dart exposure: a case report of atropine-resistant bradycardia
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DOI：10.1080/15569543.2026.2653503.png)
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Abstract
En 中文
Xylazine is a potent alpha-2 adrenergic agonist widely used in veterinary medicine and increasingly recognized as an adulterant in illicit drug markets. Accidental pediatric exposure remains rare. We report the case of a 10-year-old boy who presented four hours after being unintentionally struck by a veterinary dart containing 30 mg of 2% xylazine hydrochloride. On admission, he exhibited central nervous system depression (Glasgow Coma Scale 13), marked bradycardia (45 beats/min), and mild hyperglycemia (121 mg/dL). Intravenous atropine (0.5 mg) failed to improve the bradycardia. The patient was managed with supportive care in a pediatric intensive care unit. Heart rate and neurological status returned to baseline within 12 hours, and glucose levels normalized by 30 hours. He was discharged on the fourth hospital day without sequelae. This case highlights that low-dose parenteral xylazine exposure may produce significant toxicity in children, including atropine-resistant bradycardia.
Keywords:
Xylazine
veterinary dart injury
atropine resistance
bradycardia
Alpha-2 adrenergic agonist
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