Cotton Fever: A Condition Self-Diagnosed by IV Drug Users

Abstract

The presentation of fever in an intravenous drug user prompts diagnostic testing targeted at identifying infectious etiologies. However, an alternate diagnosis exists in "cotton fever." While few reports describe this phenomenon in the peer-reviewed literature, the diagnosis is well recognized among the intravenous drug user community. Although its etiology is not well understood, cotton fever seems to be a self-limited, febrile response to the intravenous administration of a drug filtered through cotton. Educating clinicians regarding cotton fever may limit unnecessary hospital admissions and improve our ability to care for this population. (J Am Board Fam Med 2016;29:276 -279.)

Just a Bad Case of Cotton Fever: A Case Report and Literature Review

“…Nonetheless, IE was unlikely given the lack of positive blood cultures, cardiac murmurs on physical exam, or signs of immunologic and vascular phenomena. He also showed rapid resolution of fever and significant clinical improvement within 24 hours, which is less characteristic for IE but more common in cotton fever (Table 4) [5,[9][10][11][12][13][14].…”

“…In addition to fever, other symptoms include rigors, headache, nausea, vomiting, and myalgia. This may be mistaken for a sepsis-like clinical presentation, resulting in a redundant diagnostic workup, overuse of hospital resources, and prescription of unnecessary treatments [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. We aim to raise more awareness about this disease in the healthcare community by presenting a case of cotton fever in a patient with recent intravenous (IV) methamphetamine use.…”