Naslov
Ingestion of magic mushrooms: A case report

Autori
Lovrić, Mila ; Ščavničar, Andrijana ; Rešić, Arnes, Rogić, Dunja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Skup
57th Annual Meeting of the International Association of Forensic Toxicologists

Mjesto i datum
Birmingham, Ujedinjeno Kraljevstvo, 02.09.2019. - 06.09.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
magic mushrooms ; poisoning ; psilocin

Sažetak
Aim:The aim of this study was to detect and confirm the cause of symptoms in two boys aged 15 and 16 years who were admitted to the emergency department. A cup with a liquid smelling of mushrooms and cigarettes and weed was found in the room. Methods: Targeted toxicological screening (immunochemistry) for amphetamine, cannabinoids, opiates and benzodiazepines was used. For general toxicological screening, gas chromatography-mass spectrometry (GC-MS) was used.Results: The 15-year-old boy was hyperactive and paranoic, had fear of death, he was calling his friend „daddy” and was completely in his own world. At the same time the 16-year-old boy was lying down on the kitchen floor pretending that he was talking with someone on the phone. Later he became aggressive. In ER, the 15-year-old boy was hyperactive, aggressive, out of contact ; the 16-year-old boy was lying down, occasionally answered questions coherently, and had tachycardia. Targeted toxicological screening was negative for amphetamine, opiates and benzodiazepines andrevealed positive cannabinoids in the 15-year- old boy. General toxicological screening (GC-MS) revealed psilocin in the urine samples of both boys. General toxicological screening is qualitative, but psilocin peak area on the chromatogram was about ten times higher than in the younger patient. Discussion: Clinical picture of patients was different (one was aggressive and another wasn’t), which confirms that the mind-altering effects of psilocin are highly variable and subjective. The 15-year-old patient was also positive for cannabinoids so his clinical picture was not the result of psilocin ingestion only. He also had about 10-fold greater amount of psilocin in the urine. Psilocin is a hallucinogenic alkaloid isolated from Psilocybe mushrooms. It is found in most psychedelic mushrooms together with its phosphorylated counterpart psilocybin. Psilocybin is oftenthe major component of magic mushrooms and is after ingestion rapidly converted by dephosphorylation into psilocin. The majority of psilocybin users experience a pleasant alteration inmood, but some experience panic and dysphoria. These effects typically last from three to eight hours. The psilocin found in urine was the cause of clinical symptoms in the described patients. The following morning the patients were without any symptoms of magic mushroom ingestion. Conclusion: Psilocin was confirmed in the urine sample, and qualitative confirmation along with the clinical condition of the patient is sufficient to confirm the poisoning and the need for care of patients in an emergency department.This is a valuable finding for us in clinical toxicology because this is the first case of mushroom poisoning since the GC-MS method for general toxicological screening has been applied for 24 hours. In types of poisoning that occur rarely it is, without practical experience, rather difficult to send a toxicological finding to a doctor who expects it to treat a patient, especially during night duty.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA