A 48-year-old woman in California contracted a potentially deadly meningitis infection in 2016 from smoking her favorite medical marijuana strain three to six times a day, according to a British Medical Journal case study report published last month.
The infection came from a fungus, called cryptococcus, that most people contract from inhaling contaminated dust or eating food that mouse feces have touched.
Meningitis is the most common illness to develop from exposure to cryptococcus, and causes potentially fatal inflammation in the brain and spinal cord.
Dr Bryan Shapiro, who treated the woman, says that cannabis smokers in California should be sure to know where their marijuana came from, especially if their immune systems are compromised in any way, as meningitis could be lethal for them.
A California woman who smoked three to six blunts a day got meningitis from fungus-contaminated marijuana
The unnamed woman’s sister brought her to the Cedars-Sinai Medical Center (CSMC) in Los Angeles, California. She had ‘strange symptoms,’ Dr Shapiro said, including being dizzy, tired, struggling to recall even her own name, and behaving aggressively.
In fact, her behavior had become so erratic that she was fired from her job as an administrative assistant before being admitted to the hospital.
At CSMC, the emergency room team could not figure out what was ailing the otherwise healthy patient. When she assaulted a nurse, the team called in the psychiatric department.
‘We thought it might be catatonia [abnormal movement triggered by mental issues], and it took us some time to rule out a psychiatric illness,’ Dr Shapiro said.
Still unable to diagnose her, they took a sample of her brain fluid, which tested positive for Cryptococcus neoformans, ‘a rare fungal infection usually only seen in people with late stage HIV or transplant patients,’ Dr Shapiro explained.
But the woman was otherwise in reasonably good health. The only things that stood out in her medical history were high blood pressure and a significant marijuana habit.
‘She said she had smoked between three and six marijuana blunts about daily since her teenage years,’ Shapiro said, ‘I’ve never known a patient who smokes that heavily and wondered if there could be a link between her heavy cannabis use for a lifetime.’
They treated the woman for meningitis, but if they hadn’t done so ‘prudently…there is a strong possibility she would have died, she was very, very severe at the time we saw her,’ he says.
As she was recovering, Dr Shapiro and his team investigated her favorite medical marijuana dispensary in Bakersfield where she always purchased one of the shop’s cheaper strains, which was grown locally outdoors.
DNA sequencing of nine samples revealed small amounts of the rare fungus.
‘That lent credibility to the idea that the cyrptococcus in the cannabis may have caused the woman’s systemic malfunction, and smoking might actually predispose someone to invasive fungal infection,’ Dr Shapiro said.
Fungus spores are actually grow on cannabis quite commonly.
A study conducted last year identified evidence of mold, pesticides and other contaminants on much of the weed grown in the state.
More than 90 percent of the marijuana plants tested were contaminated with pesticides, and crops from 20 farms were positive for mold.
The more you smoke, the greater the exposure [to the fungus and] the more likely it is that your body is unable to fight off the infection
Dr Bryan Shapiro, who treated the woman at Cedars-Sinai in Los Angeles
The soil in Bakersfield and the surrounding Central Valley area is known to be a breeding ground for another fungus called Coccidioides immitis, which is to blame for a slew of cases of an infection, dubbed ‘valley fever.’
Valley fever is a potentially sever lung infection and its symptoms can mirror those of the flu that has killed nearly 100 people in California since the start of the year.
The prevalence of the valley fever fungus – which causes infection when it is inhaled – in the area ‘raised suspicions’ for Dr Shapiro and his team that the soil could harbor cryptococcus as well.
The spores of these fungi are very heat resistant, so they survive even as the weed they are attached to is smoked.
Even so, it is rare for someone with an otherwise healthy immune system to get such an infection, and Dr Shapiro points to other research that has suggested that THC – the psychoactive component of weed – may itself suppress the immune system.
‘So, the more you smoke, the greater the exposure [to the fungus and] the more likely it is that your body is unable to fight off the infection,’ he says.
Dr Shapiro was unable to disclose the name of the particular dispensary that the contaminated marijuana came from, but said that it is under investigation.
This case was the first of its kind that Dr Shapiro or his team had seen, so it’s too early to make formal recommendations, he says, but advises: ‘Make sure you know where your marijuana is coming from.
‘I recommend buying indoor-grown strains and, for people who are immuno-compromised like those with HIV or other infections, I would recommend avoiding inhaled marijuana products,’ he says. Edible products, on the other hand are probably safer for consumption.