4 people in a family comes to you with burning sensation over the extremities. Some of them have also got vomiting, diarrhea. The pupils are dilated and occasional twisting of the muscles are present. What is the MOST likely cause of the symptoms?

This is a case of ergot poisoning usually as a result of eating contaminated rye bread. The burning sensation described is also called St. Anthony's fire. Due to the effect of the alkaloids ergotoxine, ergotamine, ergometrine and about 30 alkaloids present in the fungi, all the symptoms described in the question may be present. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 479