Cotton Fever – Symptoms, Duration, Causes, Sepsis, Cures, Home Remedies, Prevention

Cotton fever (CF) is a condition which is frequently associated with intravenous drug use, more exactly with the use of cotton to filter drugs, such as – heroin. It is actually caused by the bacteria which live in cotton, not by the cotton itself.

Heroin is an opioid drug made from morphine, a natural substance in the seedpod of the Asian poppy plant. It can be a brown or white powder, or a black sticky substance. Heroin can be snorted, sniffed, smoked, or injected into a vein or muscle.

Heroin is highly addictive, both psychologically and physically, therefore, the body craves it and you feel you can’t cope without it. It is estimated that around 30 million people worldwide abuse opioids. In the United States, there are over 900,000 heroin users.


It is an infection caused by Pantoea agglomerans (when an endotoxin from the bacteria is dissolved into the drug solution), a bacterium found on cotton plants, not in cotton itself.

Typically, these bacteria aren’t particularly vicious, that is why they rarely cause sepsis unless the individual has an impaired immune system to fight infections.


Many people believe that this infection is caused by cotton getting into the syringe during filtration and, subsequently, into the drug user’s bloodstream.


Symptoms of CF hit quickly and commonly occur as soon as 20 minutes after using the drug. Common symptoms may include:

  • headaches;
  • shortness of breath;
  • abdominal pain;
  • mild distress;
  • muscle pain and ache;
  • fever;
  • nausea;
  • leukocytosis (elevated white blood cell count);
  • extreme shivering and tremors;
  • join pain;
  • anxiety;
  • tachycardia (abnormally fast heartbeat);
  • a heart rate of 100 beats per minute or more when resting.


CF doesn’t usually last more than several hours.


Some people may experience sepsis, a life-threatening illness caused by the body’s response to an infection.

However, distinguishing sepsis from CF is not easy even for a doctor, because the symptoms can be very similar. Here are some signs and symptoms of sepsis:

  • fast respiratory rate (> 22 breaths/minute);
  • facial flushing;
  • elevated heart rate;
  • fatigue;
  • fever;
  • low blood pressure (≤ 100 mm Hg systolic);
  • sleepiness;
  • altered mental status;
  • dysfunction of one or more organs;
  • low urine production;
  • low body temperature;
  • skin discoloration.

Home Remedy & Cure For Cotton Fever

#1 Garlic

It is an antibacterial and antifungal agent which helps the human body fight infections as well as ward off disease.

The compound allicin that gives garlic its strong flavor is also responsible for its fever-fixing superpowers. Moreover, allicin speeds up recovery as well as it helps eliminate harmful toxins from the human body.

#2 Cool Water

Soak a washcloth in tap water and then sponge areas like your feet, armpits, groin, and hands to reduce the temperature.

#3 Bath

Taking a bath in lukewarm water may help to reduce fever safely and gradually.

Note – do not use cold water since it can actually make your body temperature to rise.

#4 Coriander

The seeds have numerous natural antibiotic compounds that make them a natural remedy to combat viral fevers.

#5 Drink It Up

When you have a fever, it is very easy to become dehydrated. To prevent dehydration, drink 8 to 12 glasses of water per day or sufficient to make your urine pale.

#6 Rest

When you rest (especially in a deep sleep), the body makes white blood cells that can attack bacteria and viruses, that is precisely what you want to happen.

Sleeping also allows the brain to trigger the release of hormones which encourage new tissue growth.

#7 Basil

This medicinal herb is just as effective as many types of antibiotics used by allopathic medicine. Its potent healing properties will help reduce fever quickly.

#8 Dress Lightly

Wear lightweight clothing to avoid overheating that may actually make the fever worse. Additionally, keep the room cool and cover yourself with a light blanket when resting.

#9 Sandalwood Essential Oil

The therapeutic and cooling attributes of sandalwood essential oil bring down the body temperature and reduce inflammation.

#10 Ginger

You can use ginger in the form of tea, by adding 1 tsp of grated ginger to 1 cup of boiling water.

When To Call The Doctor?

Fever is the result of an immune response by the body to a foreign invader. Foreign invaders include bacteria, viruses, drugs, fungi, or other toxins.

Despite what seems like popular belief, a fever less than 103 will not cause brain damage, and fever occurring from an infection will typically not go above this unless other factors are present. However, it is vital to know when you should call a doctor. Here are some things to look for:

  • you have a serious medical illness, like – sickle cell anemia (a group of blood disorders typically inherited from a person’s parents), a heart problem, cystic fibrosis, or type 2 diabetes mellitus;
  • your fever comes and goes for up to 7 days or more;
  • you have a temperature over 105 °F (40.5 °C) unless the temperature comes down readily with treatment;
  • you had no urination in the past 8 hours;
  • your fever symptoms come back after they had gone away.


The usual treatment includes:

  • ibuprofen (Advil, Motrin) can be used to break a fever. For adults, 400 mg to 600 mg can be used every 6 hours as fever reducers.
  • a prescribed course of antibiotics according to your doctor’s instructions;
  • acetaminophen (Tylenol) can be used to lower a fever. Adults without the liver disease can take 1,000 mg every 6 hours.


Since you must use cotton as a filter, it is always a danger, but there are some precautions you can take, including:

  1. Avoiding the reuse of filters, spoons, and needles of other substance users because can lead to a considerable increase in the risk of transmitting bacterial infections.
  2. When using heat to break down the heroin, let the solution cool down before dropping the cotton in.
  3. Avoiding the collection and soaking of used cotton filters to extract any residual product.
  4. Let the cotton in an open pill bottle in order to reduce the chance to develop the CF producing toxin.
  5. Micron filters are a good alternative to cotton filters and filter out more impurities than their cotton counterparts. Therefore, it is recommended to completely avoid the use of cotton filters.

Images credit- Shutterstock & Getty

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