Cotton Fever: Symptoms, Causes, & Treatment

Alternatively, some experts believe that certain individuals have pre-formed antibodies to cotton, leading to a type II hypersensitivity response. However, evidence supporting both of these theories is lacking. The theory endorsed by most evidence hypothesizes that a gram-negative bacilli Enterobacter agglomerans, a prevalent colonizer in cotton, releases an endotoxin resulting in the sequelae of symptoms . Agglomerans is not present in affected patients but has been reported in rare cases .

Cotton fever is one such health condition that is caused by intravenous drug use. The underlying cause is unsanitary drug injection practices involving the use of cotton. To prevent cotton fever and infective endocarditis, you should only use a clean needle one time to inject drugs. However, the best way to prevent cotton fever is to stop injecting drugs altogether.

Additional challenges may arise when trying to balance the use of appropriate medical resources and treating a benign, transient illness. In our case, the patient’s neutropenic fever led to ICU admission and the use of antibiotic therapy. In retrospect, given our patient’s risk factors and toxic presentation, it is difficult to determine whether these were appropriate or inappropriate management choices. Some patients may present with clinical instability requiring vasopressors .

Through strategic marketing campaign concepts, Alyssa has established Banyan as an industry leader and a national household name. •Enterobacter asburiae endocarditis is a rare complication of cotton fever. Cotton fever is usually not serious enough to require hospitalization. However, in extreme cases, cotton fever can resemble sepsis and can be misdiagnosed as such if hospitalization is required.

This often requires getting professional treatment for a substance use disorder. IV drug abuse promotes many risks, including skin diseases and blood infections. Drugs like heroin are also highly addictive, which makes it difficult to quit using and affects the individual physically and mentally.

When Do Cotton Fever Symptoms Occur?

Less than a dozen cases of cotton fever are reported in the medical literature. One case study reports that a patient developed endocarditis from a bacteria known to live on cotton fibers. Less commonly, other non-infectious etiologies include vasculitis, sympathomimetic effects of stimulant drugs, rhabdomyolysis, and cannabinoid hyperemesis syndrome . Another cause of Cotton Fever is an inflammatory infection in the blood, also known as sepsis.

In most cases, the symptoms will subside on their own within a day. However, if symptoms such as increased heart rate, fever, and nausea continue to progress it is imperative that medical attention is sought immediately. The used cotton filters seen in the spoon contain a minute amount of dissolved heroin. These cotton filters harbor bacteria along with any psychoactive substances left in them and should not be saved or soaked – the resulting solution from this process can cause cotton fever if re-injected. Obviously, the most effective way to prevent contracting cotton fever is to not inject drugs in your veins.

• Encourage people to use the filter with the smallest pore size possible to prevent harms from insoluble particles.
• The body responds to fight the infection and the immune reaction can cause life-threatening and extremely damaging complications.
• But using a dirty needle or incorporating cotton to filter the drug increases this risk.
• This illness typically lasts about 6-12 hours, but can last as long as 1-2 days in some serious cases.
• It is a common misconception that the cotton fibers used to filter intravenous drugs enter the blood stream and cause the illness.

Cotton fever got its name from drug users believing that cotton would get into the syringe during filtration. However, the main cause of cotton fever is a form of sepsis or an inflammatory blood infection that’s caused by the unsanitary and unsafe practice of intravenous drug use. Cotton fever most often occurs in people who reuse syringes or needles that contain mold or bacteria in the chamber, which is where the solution is loaded before being injected. Some people may mistakenly believe that using certain drugs puts you at risk of getting cotton fever. Instead, people get this sickness by using dirty needles or cotton when injecting IV drugs like heroin, cocaine, or other addictive substances. That said, long-term abuse of drugs like heroin or cocaine are more likely to cause cotton fever, since heavy users often inject these substances to get a faster, more powerful high.

A common risk of this practice is a condition known as cotton fever. Nonetheless, less severe cases of cotton fever should be managed in short-term observational units after an appropriate risk versus benefit analysis . This strategy may improve overall patient outcomes, provide better patient-centered care, decrease hospital costs, and limit unnecessary diagnostic studies. Furthermore, the incidence of cotton fever can be reduced through primary prevention by pharmacies and harm reduction facilities that supply cotton and membrane filters to PWIDs.

Recommended articles

It is the only bacteria to have been cultured from a patient suffering from cotton fever; however, this identification occurred in a single case report . These symptoms require medical attention and can last for several hours or even up to a full day. If you or a loved one are struggling with drug addiction, Rock Recovery Center in West Palm Beach, Florida can help.

Tell them about any drugs you have used in the past two weeks and how you used them. It can be easy to mistake wound botulism for other, more common illnesses. Your doctor needs to know if you use injection drugs, so you can be diagnosed and treated quickly and correctly. If you or a loved one is suffering from health problems like cotton fever due to IV drug use, the compassionate medical professionals at Briarwood Detox Center can help you overcome your addiction and get sober. We provide individualized drug detox Austin to treat withdrawal symptoms, ensure your safety, and help you adjust to sobriety.

• Usually cases of cotton fever do not require hospitalization because they clear up rather quickly.
• Most get it from skin popping or muscle popping black tar heroin.
• Many drug users who have had cotton fever say it’s one of the worst things they’ve ever experienced.
• Some of the other symptoms of this condition can include nausea, anxiety, elevated heartbeat, and shortness of breath.
• The differential diagnosis includes several life-threatening conditions including osteomyelitis, endocarditis, HIV, meningitis, pneumonia, cellulitis, abscess, and bacteremia .
• As sepsis is caused by transmission of bacteria from a dirty needle, using a needle only once and using a new, sterile needle every time will prevent cotton fever.

If you are a WordPress user with administrative privileges on this site, please enter your email address in the box below and click “Send”. Some of these conditions are life-threatening and require treatment. At Rock Recovery Center, we provide a life-changing process with a side of adventure to help our clients learn about themselves and nature. High ratings should be reserved for work that is truly groundbreaking in its respective field.

The majority of the epidemiological research done does not differentiate filters from other paraphernalia such as cookers and water for injection. Both McCoy ea and Faran et al. found a strong association between the sharing of paraphernalia and HIV transmission. The Sterifilt® retains considerably less active drug than other filters. Avoid using an alcohol pad after injecting as the alcohol will keep your vein open to any bacteria and/or virus. Cotton fever usually starts within the first 30 minutes after I.V administration of drugs and can last up to 48 hours. They may discuss different options that can help you quit, such as counseling, peer support groups, and medicine called buprenorphine.

You can get wound botulism even if the injection site doesn’t look infected. Alyssa who is the National Director of Digital Marketing, joined the Banyan team in 2016, bringing her five-plus years of experience. She has produced a multitude of integrated campaigns and events in the behavioral health and addictions field.

How Long Does Cotton Fever Last?

Sepsis occurs when bacteria enter the bloodstream and the body. Gebo KA, Burkey MD, Lucas GM, Moore RD, Wilson LE. Incidence of, risk factors for, clinical presentation, and 1-year outcomes of infective endocarditis in an urban HIV cohort. When someone is infected with endocarditis, clumps of bacteria form in the heart, and can then break loose and travel to different https://sober-home.org/ parts of the body. This can lead to many varied symptoms, including fatigue, aching joints and muscles, swelling in the feet and legs, and blood in the urine, among others. Investigation into the effectiveness of filters used to prepare injections made with Subutex tablets. Encourage clients to switch to drugs causing the least health problems possible.

Using filters unfit for injection – A way to minimize the risks that result from using cotton filters is to use filters made specifically for injection drug use. These specially designed filters will filter out particles over 10 microns, which is the standard of the European Pharmacopeia. The use of cotton filters, or cigarette filters, can lead to insoluble particles entering the bloodstream and causing internal sepsis, or potentially life-threatening blood poisoning.

Cotton fever should ultimately be considered a diagnosis of exclusion . If you’re worried that you or a loved one is experiencing cotton fever, you should go to the emergency room right away to seek treatment. Otherwise, in this article, we’ll help you understand more about this illness and its symptoms, what causes it, and how you can prevent it. Unfortunately, it’s very difficult to diagnose cotton fever because of its symptoms’ similarities to those of other illnesses or disorders. Cotton fever is usually a benign syndrome, meaning it is not life-threatening, but it can be severe if the issue happens often for an extended period of time. This illness typically lasts about 6-12 hours, but can last as long as 1-2 days in some serious cases.

• Antibodies, DNA and/or RNA on 18 to 36% of the used cotton filters they examined.
• Any contact with cotton as a drug filter is suspected, but another practice is thought to increase the risk.
• Sometimes, trying to sterilize cotton for drug use can lead to untreatable infections.
• When the body is fighting desperately to handle the cotton fever, it may not be able to handle the pregnancy as usual.

Ark Behavioral Health offers 100% confidential substance abuse assessment and treatment placement tailored to your individual needs. A more modern theory—the endotoxin theory—cites that a bacteria called pantoea agglomerans lives on the cotton plant. This bacteria releases an endotoxin that causes a short-term fever. One is that some people have antibodies against cotton that cause them to react to it when cotton fibers enter their bloodstream. Another is that the cotton itself contains fever-causing substances.

Symptoms of Cotton Fever

We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers. Cotton fever can occur after injecting an intravenous drug that has been filtered with cotton.

Cotton fever is a benign, self-limiting illness that occurs in IVDAs, minutes after injecting drugs through filter preparations. Common symptoms include fever, chills, myalgia, malaise, shortness of breath, chest pain, and gastrointestinal symptoms. Diagnostic workup usually shows signs of a systemic inflammatory syndrome . Risk stratification is a key element in the management of this condition.

Learn more about preventing Cotton Fever and other Skin and Soft Tissue Infections from the National Harm Reduction Coalition. Provide individually packed, sterile filters adapted to the injection of illicit drugs and oral pharmaceutical formulations. It eliminates at least 93% of all particles above 10 microns and can thus substantially reduce the serious complications due to the injection of insoluble particles (Scott, 2008; Scott, 2002; Roux et al., 2011). About 36% will present with what is known as an occult infection characterized by the presence of a fever not linked to any obvious infection. For this reason, diagnosis of cotton fever is primarily a process of elimination or a “diagnosis of exclusion”. Using and sharing injection equipment is an extremely high-risk activity and is never truly safe to do in a non-medical context.

PWIDs use cotton, membrane, or cigarette filters to remove insoluble particles from drug preparations. The retained particles are often stored and re-injected after extraction . The intravenous administration of cotton contaminants causes a sepsis-like syndrome with transient, acute-onset fever, and leukocytosis .

You will want to minimize the discomfort of withdrawal symptoms by seeking treatment. She had the usual fever, chills, and muscle aches that are characteristic of a bloodstream infection. She also complained eco sober house rating of back pain leading to the suspicion that the infection could have seeded her vertebral column. She had a markedly elevated white blood cell count suggesting a large immune response had been immobilized.

The high fever caused by the bacterium can become fatal if medical attention is not received immediately. Can discharge after 24 hours of negative blood cultures OR after symptom resolution if patient has excellent, reliable follow up. Cotton Fever is a transient flu-like illness following injection of drugs filtered through cotton. These patients should be approached as a fever of unknown origin in an IVDU. The differential diagnosis includes several life-threatening conditions including osteomyelitis, endocarditis, HIV, meningitis, pneumonia, cellulitis, abscess, and bacteremia . Patients should undergo a complete physical exam including a thorough skin exam as well as the laboratory studies and imaging listed below.

Naloxone, also known as Narcan®, can reverse the effects of an opioid overdose if given in time, but it will not reverse the symptoms of botulism. If you or someone you know gets treatment with Naloxone, but still has symptoms of botulism, see a doctor or go to the emergency room immediately. Some symptoms of wound botulism can look like symptoms of opioid overdose, such as slurred speech or inability to talk, weakness, and trouble breathing. Opioids are painkilling drugs, such as oxycodone (“OxyContin”), oxymorphone (“Opana”), hydrocodone , and hydromorphone (“Dilaudid”), as well as heroin. Fever – The fever may worsen to the point that it becomes potentially fatal. If an extended high temperature is observed the individual should receive medical care immediately.