How Does One Contract Cotton Fever, Its Symptoms and How Is It Treated?

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Cotton fever, commonly known as “dirty shot” occurs in drug addicts who have been using drugs like heroin and methamphetamine for a long time. It is caused due to a bacteria found in cotton plants called Pantoea agglomerans. 

How does one contract it?

  • The bacteria emit endotoxins before the processing of a cotton plant
  • Before injecting the drug, the user filters the drug with cotton balls
  • The user injects the drug and endotoxins enter the bloodstream
  • Symptoms of cotton fever and syndrome start developing

Another reason to contract cotton fever is using the same syringe multiple times for injecting the drugs. This causes sepsis or inflammatory blood infection. 


Seeking medical attention for cotton fever symptoms and cure is essential as it is very painful and turns fatal too. Drug users who developed cotton fever describe it as one of the worst experiences they ever had, even when compared to withdrawal.

The best treatment is to avoid taking intravenous drugs. For this the user has to go to a rehab center for a detox process followed by a therapy program. It would also eliminate all chances of contracting a cotton fever.

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Symptoms of cotton fever begin to occur within minutes or after 12 hours of injecting the drug.

  • Fever
  • Increased heartbeat
  • Pain in abdomen
  • Nausea, vomiting
  • Chills, headache
  • Muscle cramps
  • Shortness of breath
  • Increased WBC count

Any intravenous drug puts you at high risk of developing a cotton fever. However, using a dirty needle or cotton to filter the drug to be injected increases this risk further.