A January 2021 article published by Dr. Curtis McKnight and co [from Phoenix, Arizona] in the Journal of the Academy of Consultation-Liaison Psychiatry showcased  a shocking case describing a 30-year-old male with type 1 bipolar disorder and a history of intravenous drug use who was admitted after being brought to the emergency department for confusion with concerns that he was going through depressive and manic states. He reportedly had not been taking his medications but rather he had been researching ways to self-treat his depression and opioid dependence.

After reading about the therapeutic effects of hallucinogenic psilocybin mushrooms, commonly known as “magic mushrooms”, he decided to try a new approach. The man boiled the mushrooms in water and filtered the resulting liquid solution before directly injecting the solution into his veins. The man then developed nausea, lethargy, jaundice, diarrhea, and hematemesis before he was found by family members and was brought to the ED.

On initial exam, he was hypotensive to 75/47, tachycardic to 100 beat per minutes; was confused, ill-appearing with dry mucous membranes, had jaundiced skin. His ‘abdomen was diffusely tender to palpation without rebound or guarding.’

He had multiple lab abnormalities including hyponatremia (low sodium), hyperkalemia (high potassium), thrombocytopenia (low platelet), elevated cardiac enzymes, acute renal insufficiency, and acute liver injury. The man was then transferred to the Intensive Care Unit (ICU) for septic shock with multi-organ failure. Blood cultures confirmed bacteremia (Brevibacillus species) and fungemia (Psilocybe cubensis).

He was started on intravenous (iv) fluids, vasopressors, broad spectrum antibiotics (daptomycin and meropenem), and anti-fungal (voriconazole) medications. His hospital course was complicated by acute respiratory failure requiring intubation on hospital day two and disseminated intravascular coagulation (DIC) requiring plasmapheresis. He was treated for a total of 22 days in the hospital with 8 of them in the ICU.

“The case reported above underscores the need for ongoing public education regarding the dangers attendant to the use of this, and other drugs, in ways other than they are prescribed,” Dr. Curtis McKnight and his team wrote in the report.