Cotton fever is a condition that is often associated with intravenous drug use, specifically with the use of cotton to filter drugs like heroin. It has been established that the condition derives from an endotoxin released by the bacteria Pantoea agglomerans which colonizes cotton plants, not from the cotton itself. A condition similar to cotton fever was described in the early 1940s among cotton-farm workers. The term cotton fever was coined in 1975 after the syndrome was recognized in intravenous drug users. However, some sources have attributed the symptoms of cotton fever with sepsis occasioned by unsafe and unsanitary drug injection practices. This is borne out by the fact that cotton fever symptoms have occurred among all intravenous drug users, with various filter materials utilized.
Video Cotton fever
Signs and symptoms
Signs and symptoms of cotton fever usually appear within 20 minutes after injection, but may come on gradually over the course of a few hours. In addition to fever, they may include headaches, malaise, chills, nausea, extreme joint and muscle pain, a sudden onset of dull, sharp, piercing or burning back and kidney pain, tremors, anxiety, shortness of breath, and tachycardia. The fever itself usually reaches 38.5-40.3 °C (101.3-104.5 °F) during the full onset. Extreme chills and uncontrollable shivering are common. The symptoms of cotton fever resemble those of sepsis and patients can be initially misdiagnosed upon admission to a hospital.
Maps Cotton fever
Diagnosis
Contrary to most IV drug users belief that cotton fever is commonly caused by injecting tiny particles of cotton fibres, cotton fever is not due to cotton fibre particulate being injected into the bloodstream of intravenous addicts. Although terribly painful, it is actually not all that dangerous or much of a risk, especially if caught early enough and when proper medical treatment is sought after. But therein lies the problem - no one seems to be sufficiently capable or knowledgeable enough to give a straight answer about what cotton fever really is! As there are just so many different definitions out there - and every reliable information source seems to provide a slightly differing cause for this ailment. A good example of can be seen in "The Whitehouse Drug Policy's Street Drug Glossary", which defines 'cotton fever' as a "critically high temperature associated with accidentally injecting cotton fibers into the blood stream." Other rumoured causes of cotton fever circulating included "dirt in Mexican heroin" and from fiberglass bits found in cigarette filters. The connection between almost all of the definitions of 'cotton fever' is that it is caused by some kind of particulate matter that is accidentally injected into the blood stream while injecting drugs. This is not really true.
Cotton fever has specific symptoms that differentiate it from other ailments: fever, chills, and shortness of breath. In Europe, cotton fever is commonly called "the shakes"--a reference to another common symptom of cotton fever. Those with this ailment often experience violent shaking or shivering.
These symptoms normally occur immediately following an injection, but there are reports of lags up to an hour in length.
Under most circumstances, cotton fever is quite benign. Although it is possible for it to turn into something much more serious like an pneumonia (the user should watch for this, and seek medical attention if the fever does not go away). Normally however, the symptoms of cotton fever should disappear after a few hours or less, e.g. symptoms usually occur immediately following an injection, but there are reports of lags up to an hour in length.
Treatment
Cotton fever rarely requires medical treatment but is sometimes warranted if the high fever does not break within a few hours of the onset. It will usually resolve itself within a day. Soaking in a warm bath along with a fever reducer can alleviate symptoms. Extreme cases (particularly severe or long-lasting) can be treated with antibiotics.
See also
- Intravenous marijuana syndrome
Notes
References
- Shragg, Thomas (July 1978). ""Cotton fever" in narcotic addicts". Journal of the American College of Emergency Physicians. 7 (7): 279-280. doi:10.1016/S0361-1124(78)80339-6.
- Kaushik, K. S.; Kapila, K.; Praharaj, A. K. (9 March 2011). "Shooting up: the interface of microbial infections and drug abuse". Journal of Medical Microbiology. 60 (4): 408-422. doi:10.1099/jmm.0.027540-0.
External links
- Heroin Helper "Cotton Fever" Article for IV Drug Users
Source of article : Wikipedia
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