John Miller
Mushrooms are a type of fungus that have been consumed by humans since prehistory. However, not all mushrooms are edible, and mushroom poisoning can have severe and sometimes fatal consequences. Mushroom toxicity has been known for millennia and is said to have caused the death of several historical figures, including the Roman Emperor Claudius. There are approximately 100 species of toxic mushrooms out of thousands of species, and only 15-20 mushroom species are potentially lethal when ingested. Poisonous mushrooms contain a variety of different toxins, and symptoms of poisoning can vary from slight gastrointestinal discomfort to organ failure and death.
| Characteristics | Values |
|---|---|
| Number of toxic mushroom species | 100 out of thousands |
| Annual ingestions in the US | 6000 |
| Most common age group | Children under 6 |
| Symptoms | Gastrointestinal upset, organ failure, hallucinations, kidney failure, liver failure, neurologic sequelae |
| Toxins | Amatoxin, psilocybin, muscarine, coprine, allenic norleucine, gyromitrin, orellanine, muscimol, ibotenic acid, illudins, cyclopeptides |
| Poisonous mushrooms | Jack-o-lantern, Galerina marginata, Psilocybe, Conocybe, Gymnopilus, Panaeolus, Clitocybe, Inocybe, Amanita, Omphalotus spp., Gyromitra spp., Verpa bohemica |
| Edible mushrooms | Calvatia gigantea, Shaggy Mane, Morchella americana, Chanterelles |
| Prevention | Familiarity with toxic and edible species, buying from a reputable source |
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What You'll Learn
Toxicity symptoms and syndromes
Mushroom poisoning, or toxicity, occurs after the ingestion of mushrooms that contain toxins, often in the context of foraging for nontoxic, similarly-appearing mushrooms. There are up to 14 described syndromes, which manifest depending on the species, toxins, and amount ingested. The severity of mushroom poisoning may vary depending on the geographic location where the mushroom is grown, growth conditions, the amount of toxin delivered, and the genetic characteristics of the mushroom.
Early symptom category (6–12 hours): Symptoms generally appear within the first 6 hours of mushroom ingestion and include gastrointestinal (GI), allergic, and neurologic syndromes. The most common consequence of mushroom poisoning is gastrointestinal upset, including nausea, vomiting, abdominal cramping, and possibly diarrhea. However, some poisonous mushrooms cause more severe gastrointestinal distress, including abdominal pain, nausea, vomiting, and diarrhea.
Late symptom category (6–24 hours): Signs and symptoms begin to appear between 6 and 24 hours after ingestion and may include hepatotoxic, nephrotoxic, and erythromelalgic syndromes. Serious symptoms do not always occur immediately after eating, often not until the toxin attacks the kidney or liver, sometimes days or weeks later. Amatoxins, which are responsible for most mushroom-related fatalities, are synthesized by some Amanita, Galerina, and Lepiota species. Orellanine, another toxin, generally causes no symptoms for 3–20 days after ingestion, but by day 11, kidney failure begins, and symptoms such as pain in the kidney area, thirst, vomiting, headache, and fatigue are usually present by day 20.
Delayed symptom category (>24 hours): Symptoms appear more than 24 hours after ingestion and include mostly nephrotoxic syndromes. Some toxins, such as muscarine, stimulate the muscarinic receptors of nerves and muscles, causing effects such as sweating, salivation, tears, blurred vision, palpitations, and, in high doses, respiratory failure.
Hallucinogenic mushroom poisoning is the most common neurotoxic presentation of mushroom toxicity. Toxins such as psilocybin and psilocin have serotonergic properties, while muscimol is a potent, selective agonist for the GABAA receptors. Ingestion of magic mushrooms may result in horror trips combined with self-destructive and suicidal behavior, especially among people with mental or psychiatric disorders. Serious and often permanent organ dysfunction or fatalities may result from accidentally ingesting a more toxic mushroom resembling one that is hallucinogenic.
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Poisonous vs edible mushrooms
Mushrooms are the fruiting bodies of a group of higher fungi that have co-evolved with plants over millions of years. There are thousands of mushroom species, but only about 100 are toxic, and only 15-20 are potentially lethal when ingested. The consequences of misidentifying a mushroom can be severe, and mushroom poisonings may range from mild gastrointestinal upset to organ failure and death.
The majority of mushroom-related deaths are caused by species in the genus Amanita. These mushrooms grow from a sack-like or bulbous structure called a volva, which can be hidden by leaf litter or soil. The Destroying Angel (A. virosa) and the Death Cap (A. phalloides) are two of the most deadly species. Other toxic mushrooms include Galerina, Psilocybe, and Cortinarius.
To avoid poisonous mushrooms, it is recommended that novices avoid those with white gills, a skirt or ring on the stem, and a volva. Mushrooms with red on the cap or stem, or those that immediately stain blue when cut, should also be treated as poisonous. Some toxic mushrooms have a distinctive smell, such as Indian ink, iodine, or cleaning products.
When identifying edible mushrooms, it is important to be cautious. Some recommended edible mushrooms include the Giant Puffball (when fresh), the Yellow Morel, the Beefsteak Fungus, the Porcelain Fungus, and the Hedgehog Fungus. However, it is important to be 100% sure of a mushroom's identity before consuming it.
It is worth noting that boiling, cooking, freezing, or processing may not always alter the toxicity of some mushrooms. Therefore, it is crucial to correctly identify mushrooms and be aware of their potential toxicity before ingestion.
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Toxicity by species
Out of the thousands of mushroom species, only about 100 are toxic and cause the majority of poisoning cases. However, only 15-20 mushroom species are potentially lethal when ingested. The severity of mushroom poisoning depends on factors such as the mushroom's geographic location, growth conditions, the ingested toxin and amount, and the individual's characteristics. GI poisons are the most frequently encountered mushroom toxins.
Amanita species
Amanita mushrooms are responsible for the vast majority of mushroom-related fatalities worldwide. The toxins found in these mushrooms include amatoxins, which are hepatotoxic, and orellanine, which is nephrotoxic. Amanita phalloides, also known as the "death cap mushroom," is particularly deadly and can cause liver and kidney damage, with death occurring within 48 hours. Other toxic Amanita species include Amanita virosa and Amanita bisporigera, Amanita smithiana, Amanita muscaria, and Amanita pantherina.
Galerina species
Galerina mushrooms contain amatoxins, the same poison found in Amanita species. Galerina marginata, in particular, has led to fatalities when mistaken for Psilocybe species. Galerina also resembles the potentially deadly Jack O'Lantern mushroom (Omphalotus spp.), which causes gastrointestinal symptoms.
Cortinarius species
Some species in the Cortinarius genus contain orellanine, a toxin that causes kidney failure. They are also hallucinogenic and can cause serious toxicity, especially in children.
Gyromitra species
False Morels, including Gyromitra spp., contain the highly toxic and carcinogenic chemical gyromitrin, which affects the central nervous system. Gyromitrin poisoning can lead to nausea, convulsions, coma, and even death.
Psilocybe species
Psilocybe mushrooms, also known as "magic mushrooms," contain psilocybin and psilocin, which are hallucinogenic and act as agonists at 5-HT receptors. Ingestion of these mushrooms can lead to altered sensorium, euphoria, and hallucinations.
Clitocybe and Inocybe species
These mushrooms contain muscarine, a toxin that stimulates the muscarinic receptors of nerves and muscles. Symptoms of muscarine poisoning include sweating, salivation, tears, blurred vision, palpitations, and respiratory failure in high doses.
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Treatment and prevention
Mushroom poisoning is a serious and potentially fatal condition that requires immediate medical attention. If you suspect that you or someone you know has ingested a poisonous mushroom, do not wait for symptoms to occur. Contact a poison control centre or seek emergency medical care immediately. It is helpful to have a sample or a photo of the mushroom for identification purposes.
If you are foraging for mushrooms, only consume those that have been identified by an expert as safe to eat. Do not eat wild mushrooms unless you are absolutely certain of their edibility. Even washing or cooking mushrooms may not eliminate their toxicity, so when in doubt, throw them out. Stick to mushrooms purchased from reputable sources, such as supermarkets or greengrocers.
The treatment for mushroom toxicity will depend on the specific type of mushroom ingested and the symptoms presented. In general, supportive care is the primary treatment approach. This may include the administration of activated charcoal to absorb toxins, rehydration and antiemetics for gastrointestinal symptoms, benzodiazepines for hallucinations, and anticholinergic agents for cholinergic toxicity. In severe cases, liver or kidney transplants may be necessary, but organ availability is often limited.
To prevent mushroom poisoning, it is crucial to be able to identify toxic mushrooms and avoid consuming them. Familiarize yourself with both edible and toxic mushroom species, especially those that grow in your local area. Remember that toxic mushrooms can closely resemble edible ones in terms of colour, shape, and even taste. Therefore, unless you are an expert, do not consume wild mushrooms. Always cook mushrooms thoroughly, as this can reduce the risk of poisoning associated with some (but not all) toxic mushroom species.
Additionally, keep mushrooms out of the reach of children, as accidental ingestion can occur. Educate yourself and your family about the dangers of mushroom toxicity and the importance of seeking immediate medical attention if poisoning is suspected.
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Toxicity by age
While mushrooms are a recognised component of the human diet, with versatile medicinal properties, some species are toxic and can cause serious poisoning. The toxicity and symptoms of poisoning vary depending on the species and the toxin ingested. Poisonous mushrooms contain a variety of different toxins, and symptoms can range from mild gastrointestinal discomfort to organ failure and death.
Mushroom poisoning can affect people of all ages. However, young children are particularly vulnerable to accidental poisoning, as they are more likely to put things in their mouths and may not be able to distinguish between edible and poisonous mushrooms. It is important for parents and caregivers to regularly check their gardens for mushrooms and remove them to reduce the risk of accidental poisoning.
Older adults may also be at risk of mushroom poisoning, especially if they engage in foraging for wild mushrooms. Misidentification of wild mushrooms can lead to accidental ingestion of toxic species, resulting in poisoning. Adults who consume wild mushrooms should be careful to properly identify the mushrooms and be aware of the potential risks.
Pet owners should also be cautious, as pets can develop illnesses from eating wild mushrooms, including gastroenteritis and severe, life-threatening diseases. Dogs are more likely than cats to ingest mushrooms, but both types of pets can be affected. It is important to seek veterinary advice if you suspect your pet has ingested a wild mushroom.
Additionally, it is worth noting that mushroom poisoning can occur at any age if proper identification and preparation techniques are not followed. It is always recommended to only consume mushrooms purchased from a reputable source, such as a supermarket or greengrocer. If you are unsure about the safety of a mushroom, it is best to avoid consuming it.
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