1/3. "Cotton fever": a benign febrile syndrome in intravenous drug abusers.Cotton fever is a benign, self-limited syndrome that may mimic sepsis in intravenous drug addicts. We present an illustrative case and a review of the literature. Serious illness such as pneumonia and infectious endocarditis must always be considered in febrile addicts. However, trivial illness accounts for 16% to 26% of such fevers. Recent evidence suggests that emergency physicians are able to diagnose trivial illness with 93% specificity in febrile adult drug addicts. Short-term observation units may be an alternative to hospital admission for febrile drug users with a presumptive diagnosis of trivial illness and in those in whom the diagnosis of cotton fever is entertained.- - - - - - - - - - ranking = 1keywords = cotton (Clic here for more details about this article) |
2/3. enterobacter agglomerans--associated cotton fever.Cotton fever is usually a benign febrile, leukocytic syndrome of unknown etiology seen in intravenous narcotic abusers. Cotton and cotton plants are heavily colonized with enterobacter agglomerans. We report a case of cotton fever associated with E agglomerans in which the organism was first isolated from the patient's blood and secondarily from cotton that he had used to filter heroin. enterobacter agglomerans is with most probability the causal agent of cotton fever. patients presenting with the classic history should have blood cultures performed and should be started on a regimen of empiric antibiotic therapy.- - - - - - - - - - ranking = 8keywords = cotton (Clic here for more details about this article) |
3/3. Malignant hypertension presenting as blurred vision in a 43 year old intravenous drug abuser.A 43 year old intravenous drug abuser presented to the accident and emergency department with a three week history of bilateral visual loss and frontal headaches. Fundoscopy revealed bilateral retinal cotton wool spots and haemorrhages and an ophthalmic opinion was requested. His blood pressure was subsequently found to be 210/140. A diagnosis of malignant hypertension was made and blood pressure was gradually controlled on oral antihypertensives. This case illustrates the importance of checking the blood pressure of all patients presenting with visual loss.- - - - - - - - - - ranking = 1keywords = cotton (Clic here for more details about this article) |