title: Cotton Fever: Does the Patient Know Best?
abstract: Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls. While this syndrome is commonly recognized amongst the injection drug user population, there is a paucity of data in the medical literature. We review the case presentation and available literature related to cotton fever.
authors.affiliation: National Institutes of Health, Bethesda, MD, USA.
authors.forename: Yingda
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, BTE 119, Portland, OR, 97239-2997, USA. popeb@ohsu.edu.
authors.forename: Bailey A
authors.initials: BA
authors.lastname: Pope
authors.affiliation: Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, BTE 119, Portland, OR, 97239-2997, USA.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Hunter
mesh_terms: D005260:Female; D005334:Fever / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007964:Leukocytosis / Q000175:diagnosis / Q000209:etiology*; D010358:Patient Participation; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult
keywords: case report; cotton fever; drug abuse; intravenous drug abuse