Cotton Fever: Does the Patient Know Best? PMC

Cotton Fever: Does the Patient Know Best? PMC

Undermining this theory are unsuccessful attempts to isolate antibodies. If you get wound botulism and don’t get medical treatment, you might die. If you have symptoms of wound botulism, see a doctor or go to an emergency room immediately. Treatment methods for cotton fever may include detox management, blood tests and bloodwork, over-the-counter medications, and therapy. But of course, it’s better to prevent cotton fever before it happens as opposed to treating it after it starts.

In the case of pregnant women who develop cotton fever, the prognosis is not necessarily good. Without medical attention, the strain on the system can prove deadly for mother or child, or both. We understand what it’s like to feel trapped in this endless loop of on-again-off-again. The symptoms of Cotton Fever can last for hours and knowing the source of the problem may prevent this from happening again.

Any method to sterilize cotton that may contain the bacteria would likely turn the cotton toxic and possibly deadly in another manner. Toxins used to sterilize cotton may also be more difficult to treat and the damage done may be impossible to treat. Obviously, detox and a drug rehab program are the best and only long-term solutions to any and every aspect of drug use-related problems.

  • The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment.
  • Cotton fever is an uncommon, diagnosis of exclusion in patient’s with a history of recent IVDU presenting with a complaint of fever.
  • There are many reasons that injection drug use can lead to a fever, which is often a sign of something more severe.
  • This strategy may improve overall patient outcomes, provide better patient-centered care, decrease hospital costs, and limit unnecessary diagnostic studies.
  • Your doctor needs to know if you use injection drugs, so you can be diagnosed and treated quickly and correctly.

Intravenous drug use offers the most direct method of administration with the substance’s euphoric effects being almost sudden since the substance is introduced straight into the bloodstream. Roux P, Carrieri MP, Keijzer L, Dasgupta N. Reducing harm from injecting pharmaceutical tablet or capsule material by injecting drug users. People who inject illicit drugs have a risk for getting wound botulism (“BOT-choo-liz-um”), a serious illness that can be life-threatening. Your risk of getting wound botulism increases if you inject illicit drugs, especially black tar heroin, under your skin (“skin popping”) or into your muscle (“muscle popping” or “muscling”). Compared to other IV drug use risks, cotton fever is fairly benign, although just as dangerous. Cotton fever also goes away on its own, with symptoms usually dissipating after a few hours.

How injecting heroin can give you botulism

Anything above 5 should be considered above average.While all registered Cureus users can rate any published article, the opinion of domain experts is weighted appreciably more than that of non-specialists. An article’s SIQ™ will appear alongside the article after being rated twice and is recalculated with each additional rating. Cotton fever caused by bacteria from the cotton plant may be more problematic in preventing.

In many cases, symptoms of cotton fever usually resolve by themselves or with self-treatments such as medications for fever or antibiotics. If you suffer from cotton fever, laboratory testing is required to determine the cause. While lab results are pending, your healthcare team may give you an antibiotic to treat another condition.

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Every year in the United States, about 20 people are diagnosed with wound botulism. Most get it from skin popping or muscle popping black tar heroin. We don’t know how black tar heroin gets contaminated with the germ that causes botulism. Because the germ lives in soil, it might get into heroin when the drug is produced or transported, when it is cut or mixed with other substances, when it is prepared for use, or through some other way. Drug-use equipment (“works”) used to prepare or inject contaminated drugs might also spread the botulism germs to anyone who uses it. If you or someone you know has symptoms of botulism, see a doctor or go to the emergency room immediately.

Heroin and other drugs such as methamphetamine and hydromorphone are the main contributors to cotton fever. We are dedicated to transforming the despair of addiction into a purposeful life of confidence, self-respect and happiness. We want to give recovering addicts the tools to return to the outside world completely substance-free and successful.

If you need to reuse a needle, it can be sterilized with heat to kill bacteria. However, doing this doesn’t guarantee an infection won’t occur. These symptoms normally occur immediately following an injection, but there are reports of lags up to an hour in length. Particle size for differentiation between inhalation and injection pulmonary talcosis. Though drug preparations may not be filtered at all by PWID , generally they are passed through a filter in order to eliminate impurities of the drug containing solution. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page.

  • The flu-like symptoms mimic a variety of other conditions and illnesses.
  • 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.
  • Heroin and other drugs such as methamphetamine and hydromorphone are the main contributors to cotton fever.
  • However, if symptoms such as increased heart rate, fever, and nausea continue to progress it is imperative that medical attention is sought immediately.
  • She also complained of back pain leading to the suspicion that the infection could have seeded her vertebral column.
  • • Cotton fever is a diagnosis of exclusion, and likely has a higher prevalence than previously thought.

Eight hours after hospitalization, the patient’s leukocyte count increased to 6.5 x 10³ uL and absolute neutrophil count to 4.7 x 10³ uL. On follow-up 24 hours after admission, the patient showed significant clinical improvement, with resolving tachycardia. The lactic acid levels normalized and CK levels began trending down. We planned to downgrade the patient to the medical floors, de-escalate antibiotics, and obtain a transthoracic echocardiogram to rule out infective endocarditis . However, the patient decided to leave against medical advice and was unfortunately lost to follow-up. A diagnosis of cotton fever was established given the clinical presentation, lack of evidence supporting other diagnoses, and a benign, self-limiting course of the illness.

Initially, healthcare professionals believed cotton fever happens because of small fragments. They thought fragments from cotton balls got into the bloodstream during the injection. Some drug users mistakenly believe fragments and debris cause cotton fever. There are many side effects of substance abuse, including short-term and long-term ones. This can also include developing infectious diseases and emaciation.

How to Avoid Cotton Fever

These specially made filters, the Compet AG syringe filter , the „filter syringe“ and the Sterifilt® , are not yet readily available for all injection drug users. Injection drug use – Injection drug use is the underlying cause of „cotton fever“. Injection drug users often use cotton balls or other cotton products to filter the substance-containing solution. This solution passes through the filter to be injected before it enters the body. Upon injection, cotton fibers and bacteria present in the cotton filter enter the bloodstream directly.

Learn more about the risks and how to get help.Drugs If you or a loved one is struggling with drug abuse, you’re not alone. Learn more about the most commonly misused drugs.Addiction Treatment Going to a rehabilitation program greatly increases your chance of long-term recovery. Learn more about your options.Addiction Resources If you have more questions about addiction, we’ve gathered resources to help you and your loved ones. Hospital utilization and costs in a cohort of injection drug users.

cotton fever symptoms

This means that treatment is focused on reducing the discomfort of the symptoms that cotton fever causes. For those seeking addiction treatment for themselves or a loved one, the Addiction Group helpline is a private and convenient solution. Calls to any general helpline (non-facility specific 1-8XX numbers) for your visit will be answered by American Addiction Centers . However, most people who have experienced both describe cotton fever as much worse. Some even assure people with SUD will get through withdrawal if they can survive cotton fever. Drug users who have developed cotton fever describe it as one of the worst experiences they’ve ever had.


It was worse than withdrawal, to be honest,” said an anonymous source who had experienced Cotton Fever during active addiction. Let’s face it, there are a lot of things that can go wrong with IV drug abuse. There are blood clots, collapsed veins, hitting arteries, and more that can be quite painful and make life unpleasant. If you or someone you know abuses drugs intravenously, it is never too late to get help and begin recovery. If detox and sobriety aren’t options, only use clean needles once to inject drugs. But using a dirty needle or incorporating cotton to filter the drug increases this risk.

Wilson LE, Thomas DL, Astemborski J, Freedman TL, Vlahov D. Prospective study of infective endocarditis among injection drug users. Cotton fever is the result of a bacterial toxin produced by the bacteria Pantoea agglomerans which colonizes cotton plants. What occurs during cotton fever is that residuals of the endotoxin are injected along with the heroin remnants. The endotoxin stimulates a substantial immune response triggering intense symptoms but no bacteria is found as this is pure toxin-mediated. Of course, blood cultures and antibiotics should be administered initially as it is difficult to predict if viable bacteria were also injected along with the endotoxin. The risk of disease comes from cotton plants that have been heavily colonized by a strain of bacteria known as E.

Minutes after IV methamphetamine use, a 46-year-old Caucasian male presented to the emergency department with complaints of lightheadedness, nausea, vomiting, abdominal cramping, and intermittent chest pain. The history was limited because of the patient’s mental status . He reported experiencing similar episodes in the past but the current symptoms were longer in duration, which led him to seek care at our facility.

  • You will want to minimize the discomfort of withdrawal symptoms by seeking treatment.
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  • Some patients may present with clinical instability requiring vasopressors .
  • • Cotton fever is a benign febrile illness characterized by acute onset fever and leukocytosis, occurring immediately following intravenous drug injection.

Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea, and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls.

There are many reasons that injection drug use can lead to a fever, which is often a sign of something more severe. Filtration helps prevent particles that don’t dissolve from entering the bloodstream. But using a cotton ball as a filter can cause cotton fibers to get into your blood.

Medications for Addiction Treatment (MAT)

The true cause of this condition is the bacteria known as Pantoea agglomerans. Cotton Fever is a condition known by many long-term Heroin addicts and some Meth addicts, who use cotton to filter the drugs when shooting up. Cotton Fever comes from an endotoxin that is released by a bacteria called Pantoea agglomerans which colonize in cotton plants prior to being processed.

cotton fever symptoms

The rapid and intense effects of a drug that enters the bloodstream directly can be dangerous. IV drugs used for medical purposes are almost exclusively used in hospitals, where patients are closely monitored. An intravenous drug or IV drug is any drug that is injected directly into a vein. IV drugsact much fasterthan drugs consumed any other way, since they enter the bloodstream directly.

Cotton Fever is a benign, self-limited febrile syndrome commonly seen in intravenous drug users who filter their drugs through cotton balls. Cotton balls are used to filter out large particles and help ensure all of the liquid is drawn up into the syringe . Another common practice for IV drug users who have run out of drug or are trying to conserve drug is taking several used cotton balls and drawing up the remnants of left-over heroin . Medical literature on these practices or the resulting symptoms that contribute to cotton fever is limited; however, they are easily recognized amongst members of the IV drug community . Cotton fever is the street term for the post-injection fever experienced by many IV drug users after injecting or “shooting up” heroin or other drugs that have been filtered through a reused cotton ball or filter.

Patients will usually require IV fluids, antibiotics, and/or vasopressors after initial presentation. Cotton fever can be treated conservatively, with a patient-centered approach. Patients with less severe symptoms eco sober house price can be managed under medical observation. Education about avoiding re-injection of IV drugs from reused filters can also help prevent the incidence of the condition and the risk of future hospitalizations.