Mushroom-related intoxications pose a distinctive challenge for forensic medicine because early manifestations are non-specific, latency may be prolonged, and co-exposures can obscure the mechanism of death. This narrative review summarizes key toxic and psychoactive fungi and their principal compounds, spanning organ-toxic syndromes (amatoxins, orellanine) and functional neuropsychiatric intoxications—acute, predominantly functional effects causing impairment rather than organ failure (psilocybin/psilocin, ibotenic acid/muscimol). We propose an integrated diagnostic workflow combining exposure history, biochemical markers of organ injury, mycological assessment, and confirmatory toxicology. Particular emphasis is placed on postmortem interpretation: toxin instability and biotransformation, conjugation, matrix effects, postmortem redistribution (central vs. femoral blood), and postmortem fungal colonization that may alter analyte profiles or generate misleading metabolites. Because robust lethality thresholds are unavailable for most mushroom toxins, conclusions should rely on a multi-source synthesis of scene information, autopsy/histopathology, and time-dependent matrix selection (urine, gastric contents/vomitus, bile, and selected tissues; kidney for late orellanine confirmation). We review current screening and confirmatory methods—ELISA; LC-MS/MS, LC-HRMS/MS, GC-MS—and highlight pre-analytical requirements (rapid sampling, cold storage) to reduce false negatives. Finally, we discuss emerging directions such as point-of-care tests, portable mass spectrometry, and DNA barcoding for species identification.

Oncolytic viruses (OVs) are increasingly viewed not only as tumor-lysing agents but also as immunotherapeutic platforms capable of functioning as in situ cancer vaccines. By selectively infecting malignant cells, inducing immunogenic cell death, releasing tumor-associated antigens and danger signals, and activating innate and adaptive immunity, OVs can remodel immune-desert or immune-excluded tumors. This narrative review integrates mechanistic and clinical evidence on tumor-selective viral replication, antigen presentation, dendritic-cell activation, type I interferon signaling, and the recruitment of cytotoxic T lymphocytes and natural killer cells. Particular attention is given to the effects of OVs on regulatory T cells, myeloid-derived suppressor cells, tumor-associated macrophages, cancer-associated fibroblasts, and extracellular matrix barriers. We further examine the biological rationale and clinical outcomes of combining OVs with immune checkpoint inhibitors, emphasizing the discrepancy between promising preclinical findings and inconsistent clinical efficacy. A stepwise translational framework is proposed to distinguish failures in delivery and replication from inadequate immune conversion, checkpoint-restrained immunity, and non-checkpoint-dominant resistance. Finally, we discuss antiviral immunity, safety, viral engineering, and tissue-based, circulating, and genomic biomarkers that may support patient selection and guide next-generation OV-based combination strategies.