Cotton Fever: Does the Patient Know Best?

Area of Science:

• Internal Medicine
• Toxicology

Background:

• Fever and leukocytosis in injection drug users have diverse causes.
• Cotton fever is a recognized but under-documented complication of injecting drug use.

Observation:

• A case of a 22-year-old woman presented with fever and leukocytosis.
• Initial extensive workup did not reveal other causes, leading to consideration of cotton fever.
• The patient's symptoms were consistent with cotton fever, a syndrome linked to filtering drug suspensions with cotton.

Findings:

• Cotton fever is a benign, self-limited febrile syndrome.
• Characterized by fever, leukocytosis, myalgias, nausea, and vomiting.
• Occurs in individuals who use injection drugs and filter substances through cotton.

Implications:

• Increased awareness of cotton fever among healthcare providers is crucial for accurate diagnosis.
• Recognizing cotton fever can prevent unnecessary investigations and treatments for other conditions.
• Further research is needed to fully understand the pathophysiology and prevalence of cotton fever.