Cotton fever resulting in Enterobacter asburiae endocarditis

•Cotton fever is a self-limited phenomenon that occurs in IV drug users.•Colloquially known to IV drug users, cotton shooting can cause cotton fever.•Enterobacter asburiae endocarditis is a rare complication of cotton fever. “Cotton fever” is described as a self-limiting illness following “cotton shooting,” the practice of injecting residual drugs extracted from previously used cotton filters. Cases of related Enterobacter agglomerans bacteremia have been described. We report the first described case of cotton fever in a patient resulting in Enterobacter asburiae endocarditis.