• Patient with risk factors for immunosuppression (IVDU can lead to HIV due to needle sharing) presents with signs of increased intracranial pressure (papilledema and weakness of lateral rectus muscle [CN 6 palsy]) and meningitis (headache, fever, neck stiffness) with CSF findings consistent with a fungal etiology (elevated WBC count with lymphocytic predominance, low glucose)
• Key idea: Cryptococcal meningitis classically leads to meningitis symptoms + signs of elevated ICP + umbilicated skin lesions
• Note: Elevated ICP preferentially leads to a CN 6 palsy is a contested issue with two potential explanations: (1) It has the longest intracranial course and therefore is prone to stretching in setting of elevated ICP (2) CN 6 emerges straight from brain stem rather than obliquely/transversely like other cranial nerves, and is therefore more prone to compression by backward brain displacement in setting of elevated ICP

Bacterial meningitis normally makes patients more toxic appearing. High Fever (103+) and glucose would be more drastically lower.

Young IV drug user w/ weight loss makes me think of HIV infection, and so before even looking at the CSF values think opportunistic infections such as Cryptococcal meningitis, which is an AIDs defining illness.