Cotton fever is a temporary condition that can develop after intravenous injection, particularly when cotton materials are used to filter substances. It causes a rapid onset of severe, flu-like symptoms. While alarming due to its sudden nature, cotton fever is typically a self-limiting response. Understanding its triggers, management, and prevention is key.
Symptoms and Causes
Cotton fever symptoms typically appear within minutes to an hour after injection, peaking within a few hours. These commonly include an acute fever (101.3°F to 104.5°F), intense chills, and uncontrollable shivering. Individuals may also experience headache, muscle and joint pain, nausea, general malaise, shortness of breath, chest pain, or sudden back and kidney pain.
The primary cause of cotton fever is an immune system reaction to bacterial endotoxins. These endotoxins are released by bacteria, such as Pantoea agglomerans, which commonly colonize cotton plants. When cotton is used to filter substances before intravenous injection, these endotoxins can enter the bloodstream. The body’s immune system recognizes these foreign substances, triggering a systemic inflammatory response that causes cotton fever symptoms.
Managing Symptoms at Home
Managing cotton fever symptoms at home involves supportive care. Rest is important, allowing the body to recover from the intense immune response. Symptoms typically subside within 6 to 24 hours, though some residual fatigue or discomfort may linger.
Staying well-hydrated is important to combat fluid loss from fever and sweating; drink plenty of clear fluids and electrolyte solutions. Over-the-counter medications like acetaminophen or ibuprofen can reduce fever and relieve muscle aches and headaches.
For chills and shivering, wrap in warm blankets. A lukewarm bath or shower can help regulate body temperature and soothe muscle discomfort. Applying cool compresses to the forehead or neck offers additional fever relief.
When Professional Medical Care is Needed
While cotton fever is generally self-limiting, certain symptoms warrant immediate medical evaluation to rule out more serious conditions. A persistent high fever, especially one that continues to rise or lasts beyond 24 hours, should prompt medical attention. Severe difficulty breathing or chest pain also require prompt assessment.
Other indicators for seeking medical care include confusion, disorientation, or significant worsening of symptoms despite home care. Signs of a localized infection at the injection site, such as spreading redness, warmth, increased pain, or pus, also necessitate evaluation. These symptoms could indicate a more severe bacterial infection, like sepsis or infective endocarditis, requiring specific medical treatment, including antibiotics.
Reducing Risk of Recurrence
Preventing cotton fever involves minimizing the introduction of particulate matter and bacteria into the bloodstream. Use new, sterile needles and syringes for each injection, as reusing equipment can introduce bacteria and contaminants.
Proper filtration techniques are also important. Use purpose-designed sterile filters, such as wheel or micron filters, which are more effective at removing particulate matter and bacteria than improvised cotton filters. Avoid using cotton balls, Q-tips, or cigarette filters for filtration, as these materials can shed fibers and harbor bacteria.
Maintaining meticulous hygiene is another preventative measure; clean the injection site thoroughly before use to reduce bacteria on the skin. Consistent sterile practices significantly lower the chances of experiencing cotton fever and other injection-related complications.