What Is Cotton Fever? Causes, Signs, and Treatment

Following an extensive inpatient evaluation for an occult infection in a febrile injection drug user, only the serendipitous insight from the patient ultimately led to the diagnosis of cotton fever. Cotton fever is a condition that can happen to someone who has used cotton as a drug filter before injecting intravenous drugs. Its primary symptoms are an acute-onset fever and high white blood cell count. It causes a systemic inflammatory response within minutes of the intravenous (IV) drug use. Cotton fever is a well-recognized condition among people who inject drugs (PWID) but is less known among healthcare providers. This results in frequent misdiagnosis and unnecessary medical tests and treatment.

Doctors may give acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) to reduce fever and alleviate muscle aches and chills. This is an infection and can lead to a life threatening situation if it goes untreated. There are instances where Cotton Fever can be contracted without the use of a cotton filter. This is generally due to re-using a needle that may have the bacteria residue still on the needle from prior use. These symptoms normally occur immediately following an injection, but there are reports of lags of up to an hour in length. At Archstone Behavioral Health, we understand that the cost of rehab often discourages people from seeking help.

In many cases, cotton fever is a self-limited condition that requires supportive care and isn’t dangerous, but rare complications can occur. Cotton fever arises from the practice of filtering drug solutions through cotton, especially when reusing filters or extracting residual substances (“shooting the cottons”). This introduces particulate matter, including bacterial endotoxins, into the bloodstream. If you experience any of these symptoms, seek medical attention immediately, as they could indicate sepsis or another life-threatening condition. The severity of symptoms is so intense that cotton fever is often described as the worst experience of one’s life, by a long shot.

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By instituting a policy, we create a standardized approach to how we create, verify, and distribute all content and resources we produce. An editorial policy helps us ensure that any material our writing and clinical team create, both online and in print, meets or exceeds our standards of integrity and accuracy. While cotton fever can be scary—especially for someone new to these symptoms—most cases clear up on their own with proper rest and hydration.

If cotton fever is suspected, it is important to seek immediate medical help. While cotton fever symptoms usually resolve on their own within a couple of days, medical attention is necessary to rule out other potential complications and to ensure appropriate care. Healthcare professionals can provide guidance on managing symptoms, monitoring for any complications, and preventing future episodes of cotton fever. One common complication is cotton fever, which, although temporary, can be uncomfortable. However, there are far more serious consequences that can arise from IV drug use. One significant risk is the considerable reduction in life expectancy, with the average lifespan being shortened by over 18 years for those who use heroin intravenously.

If you’ve heard the term “cotton fever” in relation to intravenous drug use, you might be feeling worried or confused. Perhaps you’re concerned about a loved one who has mentioned feeling feverish and unwell after injecting drugs. Rehab insurance is a type of health insurance that covers the cost of addiction treatment, including inpatient and outpatient rehab programs, counseling sessions, and medication-assisted treatment. This means that insurance plans sold through the ACA marketplace must cover addiction treatment services, including detoxification, inpatient and outpatient treatment, and aftercare programs. However, the specific details of coverage may vary depending on the insurance plan and the individual’s specific situation. Additionally, some insurance plans may require prior authorization or limit the amount of treatment covered.

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It’s important to note that cotton fever symptoms can vary from person to person, and some individuals may experience only mild symptoms. Cotton fever is a medical condition mimicking an infection often occurring with intravenous (IV) drugs filtered through cotton fibers. It typically has symptoms like a rapid heart rate and a fever, though no infection exists. If you think someone is experiencing cotton fever, contact a professional healthcare provider. If someone’s symptoms linger beyond 24 hours or intensify, it may signal a more serious infection that needs immediate medical evaluation.

Cotton Fever Medical Treatments

• In some cases, cotton fever can lead to a rapid heartbeat, also known as tachycardia.
• The rapid and intense effects can make the drug more dangerous, as it encourages repeated use.
• In addition to addressing the immediate symptoms, medical professionals can provide guidance on safer injection practices to prevent future occurrences.
• Our licensed medical reviewers, specializing in mental health and addiction medicine, are devoted to assisting readers and potential clients in making informed decisions about their treatment.
• Organ failure and death are just some of the possible complications caused by sepsis.

His condition improved rapidly and the patient left against medical advice (AMA). Symptoms begin 15–30 minutes following injection, and are often accompanied by shortness of breath, chills, headache, myalgia, abdominal pain, nausea, vomiting and tachycardia 1. Although cotton fever is self-limited and normally lasts 6 to 12 hours, it can continue for up to 24 to 48 hours. Cotton fever is a term that may be unfamiliar to many, but for individuals who use intravenous drugs (drugs injected directly into the bloodstream), it’s a well-known and dreaded condition. Often characterized by a sudden onset of fever, chills, body aches, and flu-like symptoms, cotton fever can be alarming.

Treating an Addiction to IV Drugs

Once detox is complete, it’s followed by a full addiction treatment program on an inpatient or outpatient basis. While the treatment is individualized based on your unique history, it may include individual and group counseling, peer support groups, behavioral therapies, medication-assisted therapy, and more. Worse, it indicates that IV drug abuse has reached a dangerous level and may leave you at risk for serious infections or overdose. Symptoms of the illness include fever, headache, nausea, chills, and muscle and joint pain. There is no cure, treatment, or vaccine for cotton fever itself, however the disease is generally not serious, and the symptoms can be treated with fever reducer (like aspirin) as appropriate.

• One significant risk is the considerable reduction in life expectancy, with the average lifespan being shortened by over 18 years for those who use heroin intravenously.
• While cotton fever is usually self-limiting, repeated episodes can cause significant distress and potentially lead to more serious infections if not addressed properly.
• However, factors such as overall health, immune response, and repeated exposure to contaminants can influence how long symptoms persist.
• No, cotton fever only occurs when drugs are injected intravenously and filtered through cotton.

Pharmacologic response

The duration can vary from person to person and depends on various factors, including the individual’s overall health, the severity of symptoms, and whether any complications develop. Cotton fever symptoms usually occur immediately after the use of an IV drug that’s filtered with cotton. However, it’s a diagnosis of exclusion once other possibilities have been ruled out. Cotton fever can have intense and uncomfortable symptoms but is not usually life-threatening. If you’re using IV drugs often enough to get cotton fever, however, it is a concerning sign of drug abuse.

Resources for Support and Information

In rare cases, if left untreated or if there are complications (such as other infections), there could be serious risks. Initially described by Thomson et al. in 1975, cotton fever (or “shooting the cottons”) is an underrecognized cause of fever among medical practitioners 18. 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 19. The intravenous administration of cotton contaminants causes a sepsis-like syndrome with transient, acute-onset fever, and leukocytosis 2,17. Minutes after IV methamphetamine use, a 46-year-old Caucasian male presented to the emergency department (ED) with complaints of lightheadedness, nausea, vomiting, abdominal cramping, and intermittent chest pain.

Cotton Fever Signs, Symptoms, and Remedies

Symptoms generally last between 6 to 24 hours, with most individuals recovering within 12 hours. However, factors such as overall health, immune response, and repeated exposure to contaminants can influence how long symptoms persist. Spreading awareness and providing resources for support and information are pivotal in combating cotton fever. By educating others and ensuring access to valuable resources, we can contribute to the overall well-being and safety of individuals at risk of this condition. Administering a substance through this method leads to the fastest effects, but it has the potential to introduce toxins directly into the bloodstream that other routes of administration don’t carry.

It is crucial to understand the potential complications of cotton fever in order to prioritize seeking appropriate medical help. If you or someone you know experiences symptoms of cotton fever or any related complications, it is vital to seek medical attention promptly. Early intervention and treatment can significantly improve outcomes and reduce the risk of severe complications.

The most effective addiction treatment programs offer comprehensive, personalized care that heals cotton fever symptoms the whole person. Cotton fever runs its course without medical health care, but it’s a rare condition. 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. Cotton fever may be diagnosed if symptoms begin shortly after IV drug use and if no other health condition that explains the symptoms is present.