A 48-year-old man without prior medical history developed a paranoid psychosis with visual and auditory hallucinations that lasted five days after eating Amanita muscaria mushrooms, which he mistook for edible A. caesarea. The typical duration of symptoms from this mushroom is under 24 hours, but in this case psychosis appeared 18 hours after ingestion and persisted for five days before gradually resolving. One year later the man had no symptoms of psychiatric disease and was not undergoing therapy.
A 44-year-old woman in Slovenia developed severe hyponatremia (116 mmol/L) and plasma hypoosmolality (251 mOsm/kg) after participating in a Kambô ritual that involved applying dried skin secretion from the giant leaf frog (Phyllomedusa bicolor) to five fresh burns on her shoulder, followed by drinking 6 liters of water. Laboratory findings showed inappropriately elevated urine osmolality (523 mOsm/kg) and high urine sodium (87 mmol/L), indicating syndrome of inappropriate antidiuretic hormone secretion (SIADH). She experienced nausea, vomiting, confusion, lethargy, muscle weakness, spasms, cramps, seizure, decreased consciousness, and short-term memory loss. Treatment with 0.9% sodium chloride and water restriction improved plasma osmolality and sodium within one day, but symptoms resolved only after three days.