Wiener klinische Wochenschrift
May 1, 2006
Miran Brvar, Martin Mozina, Matjaz Bunc
37 citations
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.
Clinical toxicology (Philadelphia, Pa.)
March 1, 2025
Joep J. J. Ouwerkerk, David M. Wood, Alison M. Dines et al.
1 citation
When 3,4-methylenedioxymetamfetamine (MDMA) is taken with alcohol, emergency department visits show higher odds of agitation, drowsiness, and vomiting compared to MDMA alone. Co-intoxication with other substances increases odds of bradycardia, psychosis, and coma. Mortality rates remain low across all groups. Female patients report less chest pain but more vomiting, headache, and hypotension than males. These variations suggest that physicians should consider both the type of co-intoxication and patient sex to optimize treatment.
Toxicon : official journal of the International Society on Toxinology
September 15, 2016
Vid Leban, Gordana Koželj, Miran Brvar
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.
Toxicon : official journal of the International Society on Toxinology
November 1, 2014
Andreja Vendramin, Miran Brvar
Amanita muscaria contains more excitatory ibotenic acid and less depressant muscimol than Amanita pantherina. Patients poisoned by A. muscaria were more often confused (26 out of 32) and agitated (20 out of 32) compared to those poisoned by A. pantherina (8 out of 17 confused, 5 out of 17 agitated). Patients poisoned by A. pantherina were more commonly comatose (5 out of 17) than those poisoned by A. muscaria (2 out of 32). The findings suggest the ibotenic or pantherina-muscaria syndrome may be divided into two subtypes based on the predominant mushroom species.