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Cotton Fever: A Condition Self-Diagnosed by IV Drug Users

Ashley Michelle Zerr1, Kimberly Ku1, Areeba Kara2

  • 1From the Internal Medicine Residency (KK) and the Department of Medicine (AK), Indiana University School of Medicine (AMZ), Indianapolis; and Inpatient Medicine, IU Health Methodist Hospital, Indianapolis, IN (AK).

Journal of the American Board of Family Medicine : JABFM
|March 10, 2016
PubMed

Insights

Cotton fever is a self-limited febrile response seen in intravenous drug users, often mistaken for infection. Recognizing this condition can prevent unnecessary hospitalizations and improve patient care.

Area of Science:

  • Internal Medicine
  • Toxicology
  • Infectious Diseases

Background:

  • Fever in intravenous drug users typically prompts investigation for infectious causes.
  • Differential diagnosis often overlooks non-infectious, self-limiting conditions.

Observation:

  • Cotton fever is a recognized phenomenon within the intravenous drug user community.
  • Characterized by a febrile response after intravenous drug administration filtered through cotton.
  • Etiology remains poorly understood but appears non-infectious.

Findings:

  • Cotton fever presents as a transient febrile illness.
  • Distinct from bacterial endocarditis or other serious infections.
  • Diagnosis relies on clinical recognition in the context of intravenous drug use.

Implications:

  • Educating clinicians about cotton fever can reduce unnecessary diagnostic workups and hospital admissions.
  • Improved understanding can lead to more appropriate care for intravenous drug users.
  • Highlights the importance of considering patient community knowledge in medical diagnosis.
Keywords:
Cotton FeverIntravenous Drug Abuse

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