We considered marijuana smoking to be a possible source of exposure to the fungal antigen. However, because the marijuana smoking occurred several years prior to our patient's clinical presentation, we were unable to explore this possibility. Results of two previous studies from our group1,2 regarding fungal exposure from marijuana cigarettes revealed the presence of a number of fungi and actinomycetes, including Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Penicillium and Mucor species, Thermoactinomyces candidus, and Thermoactinomyces vulgaris. Although no Curvularia species were found in either of the two studies, we believe that recreational marijuana smoking could serve as a source for the development of fungal sinusitis.
Brummund W, Kurup VP, Harris GJ, Duncavage JA, Arkins JA. Fungal Sinusitis and Marijuana-Reply. JAMA. 1987;257(21):2915. doi:10.1001/jama.1987.03390210062013