title: Cotton Fever: A Condition Self-Diagnosed by IV Drug Users.
abstract: The presentation of fever in an intravenous drug user prompts diagnostic testing targeted at identifying infectious etiologies. However, an alternate diagnosis exists in "cotton fever." While few reports describe this phenomenon in the peer-reviewed literature, the diagnosis is well recognized among the intravenous drug user community. Although its etiology is not well understood, cotton fever seems to be a self-limited, febrile response to the intravenous administration of a drug filtered through cotton. Educating clinicians regarding cotton fever may limit unnecessary hospital admissions and improve our ability to care for this population.
authors.affiliation: From 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).
authors.forename: Ashley Michelle
authors.initials: AM
authors.lastname: Zerr
authors.affiliation: From 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).
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ku
authors.affiliation: From 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). akara@iuhealth.org.
authors.forename: Areeba
authors.initials: A
authors.lastname: Kara
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D032561:Cotton Fiber; D059026:Diagnostic Self Evaluation; D055030:Drug Users; D004452:Echocardiography; D004562:Electrocardiography; D004696:Endocarditis / Q000175:diagnosis; D005260:Female; D005334:Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D003932:Heroin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D015819:Substance Abuse, Intravenous / Q000150:complications*; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D009294:Narcotics; D000077725:Piperacillin, Tazobactam Drug Combination; D014640:Vancomycin; D003932:Heroin; D010397:Penicillanic Acid; D010878:Piperacillin
keywords: Cotton Fever; Intravenous Drug Abuse