Magic truffle intoxication: A case report

A 20-year-old man arrived at an emergency department in a state of euphoria, disorientation, intense visual hallucinations, episodic amnesia, and agitation requiring physical restraint after consuming an unusual form of hallucinogenic mushroom. The patient's family brought intact specimens, but no health professional could identify them. Toxicological screening detected psilocin in both the patient's urine and the mushrooms, guiding identification toward the Psilocybes genus. Ten hours after ingestion, the patient was discharged asymptomatic. Recognizing unusual forms of hallucinogenic mushrooms may help emergency physicians improve diagnosis and management, especially since hallucinogenic substances are not routinely tested in toxicological analyses.

Study at a glance

Abstract

Unusual forms of hallucinogenic mushrooms are emerging, which may delay diagnosis and compromise optimal management. Here, we discuss clinical and biological findings in a case of “magic mushroom” intoxication in a 20-year-old man who was brought to hospital emergency department in a state of euphoria, disorientation, intense visual hallucinations, episodic amnesia and agitation requiring physical restraint. The patient’s family brought intact specimens of the consumed product, without any health professional being able to identify it. Toxicological screening detected psilocin in urine and in the unknown mushrooms, allowing guiding the mushroom identification towards the Psilocybes genus. Ten hours post-ingestion, the patient was discharged asymptomatic. We believe that recognition of the unusual form of hallucinogenic mushroom presented here by emergency physicians might contribute to better diagnosis and subsequent optimal management, especially since hallucinogenic substances are not routinely tested in toxicological analyses.