Dynamic myocardial injury and variable hallucination latency in Psilocybe keralensis poisoning: a molecularly confirmed case series from China

Introduction Psychoactive Psilocybe spp. mushrooms pose significant public health risks. We report a cluster of Psilocybe keralensis poisonings in Chengdu, China, highlighting its unique clinical features and cardiovascular complications.Case Series Four patients ingested 16-90 g of wild mushrooms (misidentified as an edible species, but later molecularly confirmed as Psilocybe keralensis). Prodromal symptoms (e.g., dizziness) emerged within 5-20 min, but the onset of hallucinations varied widely (10-180 min). All patients developed hypertension (systolic blood pressure >150 mmHg), with one patient exhibiting rapid blood pressure elevation to 182/110 mmHg at 4 h post-ingestion, which was accompanied by evidence of myocardial injury (peak cardiac troponin T concentration 188.70 pg/mL [reference range