| Autor: |
Natasha Tobarran, John Huchison, Emily Kershner, Andrew Chambers, Kirk L. Cumpston, Brandon K. Wills |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
JEM Reports, Vol 2, Iss 2, Pp 100030- (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2773-2320 |
| DOI: |
10.1016/j.jemrpt.2023.100030 |
| Popis: |
Background: The term “cotton fever” describes a benign, self-limited febrile response within minutes following cotton filter use with intravenous (IV) drug injection. We present a case of Pantoea species (previously Enterobacter agglomerans) bacteremia related to injection of solubilized oxycodone. Case report: A 33-year-old male solubilized half of an oxycodone 5 mg tablet in tap water, filtered it with cotton and injected it intravenously. He immediately felt unwell. Initial vital signs included a temperature of 40.5 °C, blood pressure 150/107 mmHg, heart rate 170 bpm, respiratory rate 28 bpm, and SpO2 of 98% on room air. His physical exam was notable only for rigors. Initial laboratory studies demonstrated a serum lactate of 2.7 mmol/L without leukocytosis. He was treated with vancomycin and piperacillin/tazobactam for two days with resolution of fever. Blood cultures were positive for Pantoea species resistant to ampicillin and cefazolin. He continued piperacillin/tazobactam for three additional days then transitioned to oral levofloxacin for seven days upon discharge. Why should an emergency physician be aware of this?: Cotton fever describes an acute, febrile response following IV injection using cotton as a filter. The initial febrile reaction could be due to pyrogens or preformed endotoxins. Bacteremia from Enterobacter agglomerans (now Pantoea species) is possible and is frequently resistant to amoxicillin and first- and second-generation cephalosporins. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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