Cryptococcal Meningitis in an Immunocompetent Chronic Cannabis User Requiring Temporary Lumbar Drain Placement

Abstract

Background Cryptococcus is an invasive encapsulated yeast-like fungus that most commonly affects immunocompromised patients. Cryptococcal central nervous system infections, though rare, have been reported in patients without apparent immunocompromised state and in chronic cannabis smokers. Case We present a case of a 30-year-old White man with no significant medical history presenting with fever and headache of 1-month duration. He was found to have cryptococcal meningitis with persistently elevated cerebrospinal fluid pressures requiring a lumbar drain. The only risk factor identified was chronic cannabis use. Conclusions Cryptococcal meningitis though rare can occur in immunocompetent hosts. One of the risk factors identified was contaminated cannabis use. Most of these cases go undiagnosed initially as the index of suspicion is low. This may lead to increased mortality in this group of patients. In the literature search, there is only one previous report of cryptococcal meningitis in a cannabis user so the present case adds further evidence of this association.