Michael Davis
Mushroom poisoning is a serious and potentially fatal condition resulting from the ingestion of toxic mushrooms. While many mushroom species are edible, some contain toxins that can cause severe poisoning, such as amatoxin, which blocks DNA replication and leads to cell death. Misidentification of poisonous mushrooms as edible ones is a common cause of mushroom poisoning, as is intentional ingestion for recreational purposes. Symptoms of mushroom poisoning can range from gastrointestinal discomfort to death, and it is recommended to seek medical attention immediately if poisoning is suspected. In recent years, mushroom poisoning has been associated with criminal cases, such as the 2023 Leongatha mushroom murders, where Erin Patterson was found guilty of poisoning her estranged husband's family with toxic mushrooms.
| Characteristics | Values |
|---|---|
| Common causes of mushroom poisoning | Misidentification of poisonous mushrooms as edible, ingestion of wild mushrooms, ingestion by small children, intentional ingestion |
| Mushrooms responsible for poisoning | Chlorophyllum molybdites, Galerina marginata, Amanita phalloides ("death cap"), Galerina, Lepiota, Conocybe, Agaricus xanthodermus ("yellow-staining mushroom"), Psilocybe subaeruginosa ("golden top"), Hygrophoropsis aurantiaca ("false chanterelle"), Suillus species, Chlorophyllum species, Coprinus atramentarius ("inky cap"), Clitocybe, Inocybe, Amanita muscaria, Paxillus involutus, Tricholoma equestre, Shiitake mushrooms |
| Toxins found in poisonous mushrooms | Amatoxin, Arabitol, Psilocybin, Muscarine, Coprine, Allenic norleucine, Gyromitrin |
| Symptoms of mushroom poisoning | Gastrointestinal discomfort, abdominal pain, nausea, vomiting, diarrhoea, liver failure, kidney failure, neurologic sequelae, headaches, vertigo, somnolence, palpitations, dysrhythmias, rhabdomyolysis, methemoglobinemia, hemolysis, dermatitis, cramping, euphoria, altered sensorium |
| Prevention and treatment | Familiarize yourself with mushrooms and similar-looking toxic species, only eat mushrooms from reputable sources, seek medical attention immediately if poisoning is suspected |
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What You'll Learn
Misidentification of poisonous mushrooms as edible
Mushroom poisoning is usually the result of misidentifying toxic mushrooms as edible. While there are only about 100 toxic mushroom species out of the approximately 100,000 known fungi species worldwide, it only takes one misidentification to cause poisoning or even death.
The most common reason for misidentification is the close resemblance between toxic and edible mushrooms in terms of colour and general morphology. For example, the toxic Galerina marginata has been mistaken for the Psilocybe species, which are hallucinogenic. Another example is the toxic Agaricus xanthodermus, which is the most commonly eaten poisonous mushroom in Victoria, Australia, due to its resemblance to edible mushrooms. In addition, some edible Amanitas closely resemble the toxic Amanita genus, which includes the “Destroying Angel” and the “Death Cap”, the latter of which is responsible for about 9 out of 10 fungi-related deaths. The "Death Cap" is also known as Amanita phalloides, and it alone is responsible for the majority of fatal poisonings.
To avoid misidentification, it is recommended to only eat store-bought mushrooms from a reputable source, such as a supermarket or greengrocer. If you choose to forage for wild mushrooms, it is crucial to familiarize yourself with both the mushrooms you intend to collect and any similar-looking toxic species. It is also advised to have a mushroom expert (mycologist) identify a wild mushroom before consuming it. Other precautionary measures include cutting the mushroom in half vertically to check for spores or discolouration, as well as avoiding mushrooms with red on the cap or stem, those with white gills, and those with a bulbous or sack-like base.
Despite taking precautions, misidentifications can still occur, leading to poisoning. In such cases, it is important to seek immediate medical attention and contact a poison control centre for advice.
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Intentional ingestion of poisonous mushrooms
While mushroom poisoning typically occurs due to the misidentification of poisonous mushrooms as edible, many cases are the result of intentional ingestion. According to the 2020 annual report from the AAPCC National Poison Data System, 3497 of 6419 total single mushroom exposures were reported in children younger than six years old, with 413 exposures reported in those aged 6-12 years, 455 in those aged 13 to 19, and 1015 reported in those older than 19. This indicates that adults and adolescents are often involved in the intentional ingestion of poisonous mushrooms.
Furthermore, some cases of intentional ingestion arise from the desire for mind-altering experiences. For instance, the consumption of Coprinus atramentarius, commonly known as "inky cap", can lead to a disulfiram-like reaction. This reaction results in symptoms such as headaches, nausea, vomiting, flushing, tachycardia, and rarely, hypotension. Additionally, Verpa bohemica, referred to as "thimble morels" or "early morels", have caused toxic effects in individuals seeking mind-altering experiences.
It is crucial to understand that mushroom poisoning can have severe consequences, ranging from gastrointestinal upset to potentially fatal outcomes. The most common consequence of mushroom poisoning is gastrointestinal irritation, leading to vomiting and diarrhea. However, certain mushroom toxins can cause specific and deadly effects, such as liver and kidney failure, neurologic sequelae, and destruction of blood cells. The period between ingestion and the onset of symptoms varies, with some toxins taking days to exhibit symptoms. Therefore, it is imperative to seek immediate medical attention if mushroom poisoning is suspected, even before symptoms occur.
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Symptoms of mushroom poisoning
Poisonous mushrooms can lead to a range of symptoms, from mild gastrointestinal discomfort to death. The symptoms depend on the type of mushroom, the toxin ingested, and the amount consumed. It is important to note that even mild nausea can be an early sign of severe illness, and medical attention should be sought immediately if poisoning is suspected.
The most common toxin causing severe poisoning is amatoxin, which blocks DNA replication and leads to cell death. This toxin is found in the Amanita or "death cap" mushroom, which can cause death within 48 hours of ingestion. Other mushrooms with similar effects include some species of Galerina, Lepiota, and Conocybe. Ingesting these mushrooms can lead to liver and kidney failure, with symptoms such as abdominal pain, nausea, vomiting, and diarrhoea.
Mushrooms containing psilocybin cause adverse hallucinations, while those with muscarine lead to cholinergic toxicity, resulting in abdominal cramping, sweating, and bronchospasm. Coprine-containing mushrooms cause disulfiram-like reactions, leading to headaches, nausea, and vomiting. Gyromitra ingestion can result in refractory seizures, while Coprinus consumption can lead to concomitant alcohol intake and delayed symptoms.
Other manifestations of mushroom poisoning include headaches, vertigo, palpitations, rhabdomyolysis, methemoglobinemia, hemolysis, dermatitis, and cramping. Some people may also experience altered sensorium and euphoria, which can last for several hours.
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Treatment for mushroom poisoning
Mushroom poisoning is a serious and potentially lethal condition that requires medical treatment. The treatment for mushroom poisoning depends on the type of mushroom ingested and the symptoms presented. In many cases, the type of mushroom ingested is unknown, so treatment is based on the signs and symptoms exhibited by the patient.
If mushroom poisoning is suspected, it is important to contact poison control immediately. A description of the mushroom, including its colour, texture, and cap appearance, can be helpful for identification, but treatment should not be delayed while waiting for confirmation. Early volume resuscitation is crucial for liver and kidney toxic syndromes.
For patients with refractory seizures secondary to gyromitra ingestion, pyridoxine (B6) should be administered. Benzodiazepines may be a helpful adjunct. Amatoxin poisoning, which is responsible for more than 90% of deaths due to mushroom poisoning, may be treated with N-acetylcysteine (NAC), silibinin, penicillin, and antioxidant treatments. Liver transplantation may be necessary in cases of fulminant liver failure.
For patients with Cortinarius ingestion, hemodialysis may be required, and in some cases, kidney transplantation. Agitation caused by hallucinogenic mushrooms can be treated with benzodiazepines, while severe muscarinic symptoms may be treated with atropine infusions.
In cases of mushroom-induced gastroenteritis, activated charcoal can be administered orally or via NG tube every 4 hours. Biliary drainage and octreotide to prevent gallbladder contraction have also been suggested as alternative treatments.
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Criminal cases involving mushroom poisoning
In 2023, Erin Patterson, a 50-year-old mother of two, hosted a lunch for four of her estranged husband's relatives in Leongatha, Australia. Three of her guests died of death cap mushroom poisoning, while the fourth survived after weeks in intensive care.
During the nine-week trial, the prosecution argued that Patterson researched, foraged, and served the poisonous mushrooms deliberately, and lied to investigators to cover her tracks. They pointed to the fact that she disposed of a food dehydrator after the fatal meal and reset her phone multiple times. It was also alleged that she lied about having a dire medical diagnosis to ensure her guests would attend the lunch, cooked individual pastries to avoid poisoning herself, and faked symptoms to make it seem like she was also ill.
The defence argued that the poisoning was a terrible accident caused by a pantry mix-up of store-bought and wild mushrooms, which Patterson did not know were death caps. They attributed Patterson's relatively mild illness to her having induced vomiting due to an eating disorder.
After nearly two years and a lengthy trial, a jury found Patterson guilty of murdering three of her husband's relatives and attempting to murder a fourth. She faces a maximum sentence of life imprisonment.
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Frequently asked questions
There are about 6000 ingestions annually in the United States, with over half of the exposures being in children under six years old.
Symptoms can vary from slight gastrointestinal discomfort to death in about 10 days. Other symptoms include abdominal pain, nausea, vomiting, diarrhoea, headaches, vertigo, palpitations, and cramping.
If you suspect mushroom poisoning, do not wait for symptoms to occur before seeking medical attention. Contact your local poison control centre or Victorian Poisons Information Centre for advice.
Only eat mushrooms bought from a reputable source, such as a supermarket or greengrocer. Do not pick and consume wild mushrooms unless you are an expert.
In 2023, Erin Patterson was found guilty of murdering three relatives and attempting to murder a fourth by serving them beef Wellingtons containing death cap mushrooms. Another example is the case of composer Johann Schobert, who, along with his wife, children, and acquaintances, died after consuming poisonous mushrooms despite warnings.
