“Cotton fever” is a condition experienced by individuals who inject drugs. It causes a sudden onset of alarming symptoms, leading to concerns about its potential threat to life. This article provides information about cotton fever, including its causes, symptoms, and steps for treatment and prevention.
Understanding Cotton Fever
Cotton fever is a temporary illness with sudden fever and flu-like symptoms, appearing shortly after injecting drugs filtered through cotton. It is caused by foreign particles, specifically cotton fibers and associated bacteria/endotoxins, entering the bloodstream during injection. The bacteria, commonly Pantoea agglomerans, naturally reside on cotton plants and can be present on cotton filters.
When these contaminants enter the body, they trigger a rapid immune response. This leads to acute symptoms, often appearing within 20 to 30 minutes. Common manifestations include a sudden high fever (101.3–104.5 °F), intense chills, severe body aches, nausea, and headaches. These symptoms usually resolve within a few hours to a day.
Assessing the Risks
While cotton fever symptoms can be severe and mimic serious infections like sepsis, direct fatalities are extremely rare. The condition is self-limiting, often resolving without specific medical intervention. However, cotton fever involves foreign material entering the bloodstream, which can lead to complications.
The body’s immune response to foreign particles and endotoxins can initiate a systemic inflammatory response. In some cases, this progresses to bacterial infections or, rarely, sepsis, a life-threatening condition where the body’s response to an infection damages its own tissues and organs. Individuals with compromised immune systems, existing heart conditions, or those with repeated episodes are at elevated risk for severe outcomes. Complications can include infective endocarditis, a bacterial infection of the heart lining, or spinal epidural abscesses. Therefore, seeking medical attention for severe or persistent symptoms is important to rule out these more dangerous conditions.
Treatment and Prevention
Medical attention for cotton fever focuses on supportive care to manage symptoms and ensure comfort. This involves providing fluids for hydration and administering over-the-counter medications to reduce fever and pain. While cotton fever often resolves independently, antibiotics may be prescribed if a bacterial infection is suspected or confirmed. Seek immediate medical attention if symptoms are severe, do not improve within 12-24 hours, or include signs like chest pain, difficulty breathing, or confusion.
Preventative measures are important to reduce cotton fever risk. These strategies center on harm reduction related to injection practices. Using new, sterile injection equipment, including needles and syringes, for each use significantly lowers the risk of introducing contaminants. Proper filtering techniques, such as using sterile membrane filters instead of improvised cotton materials, can also prevent cotton fibers and bacteria from entering the bloodstream. Maintaining hygiene by washing hands and cleaning injection sites before use further minimizes infection chances.