Acute Kidney Failure and Myocarditis Triggered by Magic Mushroom Toxicity in a Patient With Prior Cocaine Exposure

Magic mushroom poisoning can be associated with acute kidney injury (AKI), primarily due to ischemic acute tubular necrosis (ATN). Additionally, the use of cocaine can lead to both venous and arterial thrombosis through its vasoconstrictive and prothrombotic effects. In this article, a middle-aged gentleman with a previous history of cocaine use was admitted with severe anuric AKI requiring dialysis after magic mushroom poisoning. He developed supraventricular tachycardia (SVT) with significantly raised troponin T and severe left ventricular dysfunction, which was thought to be due to myocarditis induced by magic mushrooms. In addition, imaging revealed extensive thrombosis in multiple blood vessels, including the abdominal aorta, superior mesenteric artery (SMA), and bilateral iliac arteries, resulting in right kidney infarction and a pulmonary embolism in the right lower lobe. There is also a possibility that psilocybin-containing magic mushrooms may induce vasoconstriction, which could theoretically contribute to thrombotic events. However, direct evidence linking psilocybin to thrombosis remains limited.