Mushrooms
There are more than 5000 varieties of mushrooms, of which about 50–100 are known to be toxic and only 200–300 are known to be safely edible. The majority of toxic mushrooms cause mild to moderate self-limited gastroenteritis. A few species may cause severe or even fatal reactions. The major categories of poisonous mushrooms are described in Table II–38. Amanita phalloides and other amatoxin-containing mushrooms are discussed in Mushrooms, Amatoxin-Type.
Syndrome | Toxin(s) | Causative Mushrooms | Symptoms and Signs |
|---|---|---|---|
Delayed gastroenteritis and liver failure | Amatoxins (See Mercury) | Amanita phalloides, Amanita ocreata, Amanita verna, Amanita virosa, Amanita bisporigera, Galerina autumnalis, Galerina marginata, and some Lepiota and Conocybe spp | Delayed onset 6–24 hours: vomiting, diarrhea, abdominal cramps, followed by fulminant hepatic failure after 2–3 days. |
Delayed gastroenteritis, CNS abnormalities, hemolysis, hepatitis | Monomethylhy-drazine | Gyromitra (Helvella) esculenta, others | Delayed onset 5–8 hours: vomiting, diarrhea, followed by dizziness, weakness, headache, ataxia, delirium, seizures, coma; hemolysis, methemoglobinemia, hepatic and renal injury may also occur. |
Cholinergic syndrome | Muscarine | Clitocybe dealbata, Clitocybe cerrusata, Inocybe cincinnata | Onset 30 minutes–2 hours: diaphoresis, bradycardia, bronchospasm, lacrimation, salivation, sweating, vomiting, diarrhea, miosis. Treat with atropine (See Atropine and Glycopyrrolate). |
Disulfiram-like reaction with alcohol | Coprine | Coprinus atramentarius, Clitocybe claviceps | Within 30 minutes after ingestion of alcohol: nausea, vomiting, flushing, tachycardia, hypotension; risk for reaction for up to 5 days after ingestion of fungi (see “Disulfiram”). |
Isoxazole syndrome | Ibotenic acid, muscimol | Amanita muscaria, Amanita pantherina, others | Onset 30 minutes–2 hours: vomiting, dizziness followed by drowsiness, muscular jerking, hallucinations, delirium, rarely seizures. |
Gastritis and renal failure | Allenic norleucine |
