A 32-year-old man presented with 1-month history of enlarging necrotic chest wounds. He reported a 3-year history of daily use of fentanyl by injection into his neck and arm veins. CT of the chest showed osteomyelitis of the clavicles and manubrium, in addition to soft-tissue ulceration and inflammation. Adulteration of fentanyl by which of the following substances is most likely to have contributed to the development of these superinfected wounds?
患者男，32岁，因胸部坏死伤口扩大1个月就诊。患者自诉有3年的颈静脉和手臂静脉每日注射芬太尼史。胸部CT显示锁骨和骨柄骨髓炎，以及软组织溃疡和炎症。芬太尼掺入下列哪一种物质最有可能导致这些重叠感染伤口的发生?
A. Cocaine 可卡因
B. Levamisole 左旋咪唑
C. Methamphetamine 冰毒
D. Talcum powder 滑石粉
E. Xylazine 甲苯噻嗪
答案解析：
Xylazine，又称“镇定剂”，是一种只被批准用于兽医的α2肾上腺素能受体激动剂。在美国，它是芬太尼的一种越来越普遍的添加剂。Xylazine与皮肤损伤相关，无论注射部位如何。患者接受了胸壁清创和显微外科皮瓣重建，随后接受了6周的静脉抗感染治疗。他还因阿片类药物使用障碍接受了丁丙诺啡治疗。
正确答案：E
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