Buy Cuban Cubensis
Psilocybe cubensis is a species of psychedelic mushroom whose principal active compounds are psilocybin and psilocin. Commonly called shrooms, magic mushrooms, golden tops, cubes, or gold caps, it belongs to the fungus family Hymenogastraceae and was previously known as Stropharia cubensis. It is the most well known psilocybin mushroom due to its wide distribution and ease of cultivation. Buy Cuban Cubensis
A 15-year-old male bought a “grow kit” for Psilocybe cubensis mushrooms from an online website. He germinated the spores into mushrooms and ate his “harvest” with three of his friends. All boys experienced hallucinatory effects, which resolved completely over a 6-h period.
36 h after ingestion, the patient developed nausea, abdominal discomfort and low back pain. He did not experience vomiting, diarrhea, or fevers. Initial bloodwork ordered by his primary care provider showed a creatinine of 207 micromoles/L.
After two days, the patient’s symptoms persisted. Repeat bloodwork showed worsening of his renal function with a creatinine of 444 micromoles/L (reference range 65–121 micromoles/L) and a urea of 13. 5 mmol/L (reference range 3.0–7.0 mmol/L). He was referred to a pediatric tertiary care hospital, where he was admitted with further evaluation by the nephrology team. On the day of admission (day zero) he was hypertensive with a blood pressure of 144/85. Admission bloodwork included a CBC, LFTs, electrolytes, calcium panel, blood cultures and a CK. All were within the normal ranges, with the exception of an elevated phosphate (1.98 mmol/L, reference range 0.90–1.50 mmol/L). Urine microscopy revealed 5–10 red blood cells per high power field (RBC/HPF), and no protein, leukocytes, or casts. A renal ultrasound showed normal-sized kidneys bilaterally and enhanced cortical echogenicity. Additional investigations included normal complement levels, negative antistreptolysin O titres, negative urine cultures and two sets of negative blood cultures.
Prior to definitive identification of the ingested mushrooms, the initial clinical presentation appeared consistent with possible ingestion of an orellanine-containing mushroom. During his hospital stay, he received supportive care with IV fluids, hydralazine for hypertension, and IV N-acetyl cysteine based on case reports of benefit for orellanine-induced renal injury. On day 5 post-admission, he was discharged home. Serum creatinine and phosphate levels were resolving at 108 micromoles/L and 1.68 mmol/L respectively. Having ruled out infectious and rheumatologic causes, the discharge diagnosis was presumed AKI from mushroom ingestion.
At a 3-month follow up visit, the patient remained asymptomatic, with normal blood pressure and full recovery of his renal function. His creatinine was 80 micromoles/L, with a urea of 4.7 mmol/L, and normal electrolytes. Urinalysis was normal.
A sample of the crop of mushrooms yielding the ingested specimens was sent to a mycologist who identified the species as Psilocybe cubensis . The identification of the mushroom sample was based on shared characteristics with published descriptions of the Psilocybe cubensis mushroom, including the overall stature of the basidome, the presence of a prominent annulus derived from a partial veil, a blue-staining reaction of tissues, coloring of the pileus and the stipe, the concentric arrangement of the scales, and the lamellae bearing purple-brown basidiospores with germ pores. A sample of the mushroom crop was further analyzed by mass spectrometry (LC-MS/MS). Briefly, 5–10 μL of extracted mushroom (in methanol) was injected and separated using a ToxTyper (Bruker) triple quadrupole liquid chromatography coupled to mass spectrometer (LC-MS/MS). The sample was analyzed in alternating polarity mode using the Toxtyper system equipped with an electrospray ionization source. Full scan MS, MS2 and MS3 spectra were acquired in data dependent MS/MS mode. The Toxtyper system identifies compounds based on retention time, MS, MS2, and if necessary, MS3 information. A peak was identified with a retention time of 2.5 min, corresponding to psilosin. No other peaks were identified, including for orellanine or amatoxin.