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Here is a quick rundown of what to look for: Abnormal heart rate Elevated white blood cell count Chills Abdominal pain Fever Mild distress Headache Muscle pain and aches Vomiting Shortness of breath Nausea These symptoms also fall in line with the symptoms for a condition known as Inflammatory Response Syndrome. Causes of Cotton Fever IV drug users have been familiar with cotton fever for a long time. Facebook Instagram Youtube. Have Questions? This field is for validation purposes and should be left unchanged.
Opium Tincture Abuse and Overdose Opium tincture is a liquid prescription drug that consists of opium powder dissolved in alcohol ethanol. When it comes to people addicted to heroin, for example, users may resort to sucking the substance out of cotton balls. However, there are many more reasons that someone may contract cotton fever.
Cotton fever is most common among heroin users who take the drug via injection. Heroin and other drugs such as methamphetamine and hydromorphone are the main contributors to cotton fever. However, the direct causes are still not entirely clear. These symptoms can occur anywhere from minutes after using a drug.
How should a provider manage a patient they suspect is suffering from Cotton Fever? Background: Cotton Fever is a benign, self-limited febrile syndrome commonly seen in intravenous IV drug users who filter their drugs through cotton balls. Mechanism of Action: The exact mechanism of action regarding the pathophysiology of Cotton Fever is unknown, however, there are three prevailing theories 3. Pharmacologic Theory: Substances within the cotton material have pyrogenic activity Immunologic Theory: Some patients have performed antibodies to cotton Endotoxin Theory: Gram negative bacilli are taken up in the cotton and release endotoxins Enterobacter agglomerans recently renamed to Pantoea agglomerans has been implicated with Cotton Fever.
It is the only bacteria to have been cultured from a patient suffering from cotton fever; however, this identification occurred in a single case report 4. Interestingly though E.
Clinical Presentation: Symptoms include nausea, vomiting, fever, chills, headache, myalgias, abdominal pain, and tachycardia. Onset is usually minutes following IVDU with the use of cotton. Symptoms usually persists for hours but can extend as long as hours. These patients should undergo admission and observation until a hour negative blood culture result has been achieved.
Often patients who are familiar with this illness will request to be discharged once they are feeling better 6. Given the severity of other illnesses on the differential that are associated with fever in IVDU it is recommended that patients who have reliable, close follow up be discharged before completing their workup 2.
Key Points: Cotton Fever is a transient flu-like illness following injection of drugs filtered through cotton.
May be secondary to endotoxin release from gram negative bacilli in cotton Diagnosis of exclusion. Management is aimed at symptomatic treatment and empiric antibiotics.
Can discharge after 24 hours of negative blood cultures OR after symptom resolution if patient has excellent, reliable follow up. Again, cotton balls are commonly used for this purpose since they are so cheap and readily available.
Once a drug is in liquid form, a person draws the substance through the filter and into the syringe. Heroin is most closely associated with cotton fever. But a Journal of General Internal Medicine JGIM article notes that hydromophone or a combination of pentazocine and methylphenidate have also been linked to the condition. Unlike many of the other medical risks associated with IV drug abuse, cotton fever is considered to be a benign syndrome. Cotton fever also resolves on its own, with symptoms typically dissipating in six to twelve hours.
More severe cases may last one to two days. Intravenous drug use is associated with a host of illnesses and disease. Many of these, like cellulitis , endocarditis, and even pneumonia can cause symptoms which are similar to cotton fever. This similarity can cause two problems. Cotton fever can be overlooked or misdiagnosed, leading to unnecessary and prolonged medical care.
Call now to be connected with one of our compassionate treatment specialists. Secondly, other illnesses could be misdiagnosed as cotton fever.
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