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Neurotoxicity associated with the medicinal mushroom product-Diamond Shruumz: A case report

Summary

A 17-year-old girl became severely ill after eating a chocolate bar containing a medicinal mushroom product that was contaminated with muscimol, a toxic compound from poisonous mushrooms. She experienced confusion, uncontrollable muscle jerks, dilated pupils, and excessive drooling, requiring hospitalization and temporary breathing assistance. Though her symptoms resolved within 8 hours and she recovered fully, this case highlights the serious danger of unregulated mushroom supplements that can be contaminated with deadly toxins.

Background

Medicinal mushrooms are increasingly popular as dietary supplements with purported health benefits, but the FDA does not regulate these products for ingredient quality and contents. This places consumers at risk for contamination with toxic mushroom species, particularly from the Amanita genus, which can cause serious neurotoxicity.

Objective

To describe a case of acute neurotoxicity in an adolescent following ingestion of a medicinal mushroom product contaminated with muscimol, the primary toxin of Amanita muscaria, and to characterize the clinical presentation and toxidrome.

Results

The patient presented with a mixed cholinergic and antimuscarinic toxidrome including confusion, myoclonus, mydriasis, bronchorrhea, and post-ingestion amnesia consistent with muscimol toxicity. She required intubation for airway protection but experienced spontaneous symptom improvement and resolution within 8 hours of presentation. She was discharged the following day without complications.

Conclusion

This case demonstrates the neurotoxicity risk from contaminated medicinal mushroom products and represents one of over 150 cases in a documented outbreak of Diamond Shruumz products containing muscimol. As medicinal and hallucinogenic mushroom products proliferate in the market, healthcare providers and the public should be aware of contamination risks and potential for serious neurotoxic effects requiring supportive care.
  • Published in:Toxicology Reports,
  • Study Type:Case Report,
  • Source: PMID: 39386889, DOI: 10.1016/j.toxrep.2024.101748
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