[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-461692-105":59,"doc-detail-461692-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","fatal-multiorgan-dysfunction-syndrome-secondary-to-cocaine-toxicity","Fatal Multiorgan Dysfunction Syndrome Secondary to Cocaine Toxicity","","Cocaine toxicity is a well-recognized trigger for multiorgan dysfunction driven by sympathomimetic, vasoconstrictive, and prothrombotic mechanisms. Severe presentations may progress to cardiogenic shock, rhabdomyolysis, acute kidney injury, and acute hepatic failure. A 50-year-old woman with substance use disorder arrived with cocaine intoxication unresponsive to naloxone, required intubation, developed distributive shock needing triple vasopressors, and experienced recurrent cardiac arrests. Despite CRRT, broad-spectrum antibiotics, and maximal supportive care, she remained comatose with progressive multiorgan failure and died on day three, underscoring often fatal systemic complications.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/fatal-multiorgan-dysfunction-syndrome-secondary-to-cocaine-toxicity/461692/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/fatal-multiorgan-dysfunction-syndrome-secondary-to-cocaine-toxicity/461692.png","ImageObject",300,407,{"name":92,"@type":93},"ahduag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why can cocaine intoxication lead to multiorgan dysfunction?","Question",{"text":113,"@type":114},"Cocaine exerts potent sympathomimetic, vasoconstrictive, and prothrombotic effects, which can cause extensive injury across cardiovascular, renal, hepatic, pulmonary, and neurologic systems.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What treatments were provided in this case after cocaine intoxication?",{"text":118,"@type":114},"The patient required endotracheal intubation and mechanical ventilation, triple vasopressor support for distributive shock, continuous renal replacement therapy, empiric broad-spectrum antibiotics, and maximal supportive care.",{"name":120,"@type":111,"acceptedAnswer":121},"What laboratory and clinical findings supported organ injury?",{"text":122,"@type":114},"Findings included rhabdomyolysis with markedly elevated creatine kinase, acute kidney injury with high creatinine, elevated troponins, severe metabolic acidosis, and evidence of hepatic injury, along with CT findings of bilateral lung consolidation and subcutaneous emphysema.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},461692,1790790787,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747870414,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Review began 11/15/2025  \nReview ended 12/04/2025  \nPublished 12/10/2025  \n© Copyright 2025  \nChowdhury et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98906  \nOpen Access Case Report  \nFatal Multiorgan Dysfunction Syndrome Secondary to Cocaine Toxicity  \nTutul Chowdhury 1, 2, Anusha Akella 1, Aditi Parulkar 1 , Nisha K. Sapkota 1 , Mujibur Majumder 2  \n1. Internal Medicine, Interfaith Medical Center, Brooklyn, USA 2. Pulmonary and Critical Care Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA  \nCorresponding author: Tutul Chowdhury, [ctutul@yahoo.com](ctutul@yahoo.com)  \nAbstract  \nCocaine toxicity is a well-recognized cause of multiorgan dysfunction due to its potent sympathomimetic, vasoconstrictive, and prothrombotic effects. Severe cases can result in cardiogenic shock, rhabdomyolysis, acute kidney injury (AKI), and acute hepatic failure. We describe a case of a 50-year-old female with a history of substance use disorder who presented with cocaine intoxication, unresponsive to naloxone, and required intubation. She developed distributive shock requiring triple vasopressor support and suffered recurrent cardiac arrests with temporary return of circulation. Laboratory findings showed rhabdomyolysis (creatine kinase (CK) 29,074), AKI (creatinine 5.8 mg/dL), elevated troponins (9,978 ng/L), severe metabolic acidosis, and hepatic injury. Despite continuous renal replacement therapy (CRRT), empiric broad-spectrum antibiotics, and maximal supportive care, she remained comatose with progressive multiorgan failure and expired on hospital day three. This report underscores the severe systemic and often fatal complications of cocaine toxicity.  \nCategories: Internal Medicine, Nephrology, Pulmonology  \nKeywords: ards (acute respiratory distress syndrome), cocaine-induced lung injury, cocaine toxicity, continuous renal replacement therapy (crrt), ischemic organ injury, multi organ dysfunction syndrome (mods), multi-system organ failure, non-traumatic rhabdomyolysis  \nIntroduction  \nCocaine is a potent stimulant derived from the coca plant and continues to pose a significant global public health challenge because of its widespread misuse and potentially life-threatening complications [1] . Its sympathomimetic and vasoconstrictive effects can cause extensive multiorgan injury involving the cardiovascular, renal, hepatic, pulmonary, and neurological systems. The overall mortality rate in acute cases varies, with some studies documenting rates of approximately 3.8% or higher, depending on the severity of organ failure [2] . While often perceived as producing only short-lived effects, cocaine toxicity can lead to severe and irreversible damage, including rhabdomyolysis, ischemic organ injury, and cardiac arrest [2] . We present a case of fatal multiorgan failure secondary to cocaine intoxication, highlighting the severe systemic effects of this drug.  \nCase Presentation  \nA 50-year-old female with a past medical history of substance use disorder was brought into the emergency department for suspected drug intoxication. The patient was administered Narcan but did not respond and was noted to be significantly altered. She remained obtunded and required endotracheal intubation with initiation of mechanical ventilation. On admission, urine toxicology came out positive for cocaine. On presentation, vitals showed blood pressure of 100/34 mmHg with a mean arterial pressure of 57, heart rate of 100 beats per minute, and temperature of 98 .7 °F. On examination, pupils were reactive to light but anisocoric, with the left pupil measuring 1 mm and the right 2-3 mm. Extremities were cool to the touch, suggesting poor perfusion. Labs on admission are presented in Table 1.  \nHow to cite this article  \nChowd","cbCaivTIcvrg8Skq","https://ap.wps.com/l/cbCaivTIcvrg8Skq","pdf",2043699,"English","# Abstract\n# Introduction\n# Case Presentation\n# Investigation\n## Table 1: Lab studies on day 1\n## Imaging and cultures (CT chest, head; culture results)\n## Hemodynamic support (vasopressors)","[{\"question\":\"Why can cocaine intoxication lead to multiorgan dysfunction?\",\"answer\":\"Cocaine exerts potent sympathomimetic, vasoconstrictive, and prothrombotic effects, which can cause extensive injury across cardiovascular, renal, hepatic, pulmonary, and neurologic systems.\"},{\"question\":\"What treatments were provided in this case after cocaine intoxication?\",\"answer\":\"The patient required endotracheal intubation and mechanical ventilation, triple vasopressor support for distributive shock, continuous renal replacement therapy, empiric broad-spectrum antibiotics, and maximal supportive care.\"},{\"question\":\"What laboratory and clinical findings supported organ injury?\",\"answer\":\"Findings included rhabdomyolysis with markedly elevated creatine kinase, acute kidney injury with high creatinine, elevated troponins, severe metabolic acidosis, and evidence of hepatic injury, along with CT findings of bilateral lung consolidation and subcutaneous emphysema.\"}]","Fatal Multiorgan Dysfunction Syndrome Secondary to Cocaine Toxicity | PDF",1790762169,15]