John Miller
Mushroom toxicity has been known for millennia and is implicated in the deaths of several historical figures, including the Roman Emperor Claudius. Many different species of mushrooms are poisonous and contain varying toxins that cause different types of harm. The most common toxin that causes severe poisoning is amatoxin, which is found in various mushroom species and causes the most fatalities annually. Amatoxin blocks DNA replication, leading to cell death and potential liver failure. Despite the dangerous symptoms, amatoxin poisoning is treatable with quick, professional care. Poisoning may also be caused by misidentification of poisonous mushrooms as edible, or intentional ingestion. While mushroom toxicity can be fatal, it is not always deadly.
| Characteristics | Values |
|---|---|
| Number of toxic mushroom species | 100 out of 6000 |
| Number of ingestions in the US per year | 6000 |
| Percentage of ingestions in children under six years | Over 50% |
| Toxins | Amatoxin, Psilocybin, Muscarine, Coprine, Allenic Norleucine, Gyromitrin, Orellanine |
| Poisoning symptoms | Gastrointestinal upset, nausea, vomiting, abdominal pain, diarrhoea, abdominal cramping, liver failure, kidney failure, neurologic sequelae, seizures, hallucinations, euphoria, altered sensorium, abdominal cramping, diaphoresis, salivation, lacrimation, bronchospasm, bronchorrhea, bradycardia, myocardial infarction, rhabdomyolysis, acute renal failure, posterior encephalopathy, psychosis, loss of muscle contraction |
| Most toxic mushrooms | Death cap (Amanita phalloides), Destroying angels (A. virosa, A. bisporigera, A. ocreata), Fool's mushroom (A. verna), Deadly webcap (C.) |
| Fatality rate for Amanitin poisoning | 50% without prompt medical treatment, 10% in the US |
| Poisonous lookalikes | Jack-o-lantern mushrooms (Omphalotus spp.), Galerina marginata, Psilocybe species, Chlorophyllum molybdites (greengills), Entoloma (pinkgills), Verpa bohemica, Morels, Agaricus xanthodermus |
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What You'll Learn
Amatoxin poisoning
The liver is the principal organ affected by amatoxin poisoning, as it is the first organ encountered after absorption in the gastrointestinal tract. However, amatoxins can also damage many other organs, including the heart, kidneys, and central nervous system. The symptoms of amatoxin poisoning include nausea, vomiting, abdominal pain, diarrhoea, dizziness, insomnia, shortness of breath, coughing, and gastrointestinal disturbances. In severe cases, amatoxin poisoning can lead to liver failure, kidney failure, and death.
The treatment of Amatoxin mushroom toxicity is predominantly supportive care, with no specific antidote currently available. Patients must have two large-bore IVs, and fluid loss, electrolyte deficiency, and glucose should be normalized. If the patient presents early (within two to four hours), decontamination with oral activated charcoal may be performed. N-acetyl-cysteine, a high dose of penicillin, and silymarin have also been used to treat potential liver injury.
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Poisonous lookalikes
Poisonous mushrooms were once called toadstools. They look very similar to edible mushrooms, with most having stems, caps, gills, and other similar features. The difference between edible and poisonous mushroom species is sometimes very subtle, and only an expert can tell the difference.
- Death Cap (Amanita phalloides): This is perhaps the deadliest of all mushrooms, found throughout Europe. It closely resembles edible straw mushrooms and Caesar's mushrooms. Its toxins are heat-stable and quickly damage cells throughout the body.
- Destroying Angel (Amanita virosa, Amanita bisporigera, and Amanita ocreata): These mushrooms are similar in appearance to edible button mushrooms and meadow mushrooms. They are incredibly toxic and have been mistakenly collected on numerous occasions.
- Jack O'Lantern Mushroom (Omphalotus spp.): This mushroom is sometimes mistaken for the Chanterelle, as both are bright orange and fruit at the same time of the year. However, the Jack O'Lantern grows on wood and has gills instead of veins.
- Fool's Webcap (Cortinarius orellanus): This mushroom is very similar in appearance to several edible varieties. It contains orellanine, which causes kidney failure if left untreated.
- Autumn Skullcap (Galerina marginata): This mushroom is similar to the hallucinogenic Psilocybe mushroom, but it contains the same amatoxins as the deadly Amanita species.
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Gastrointestinal distress
The onset of gastrointestinal distress after consuming toxic mushrooms can vary. Some people may experience symptoms within 15 to 30 minutes of ingestion, while others may not show symptoms until 6 to 24 hours later. In some cases, symptoms may take up to 21 days to appear. The timing of symptom onset depends on the specific toxin ingested. For example, Amatoxin poisoning typically causes symptoms to appear after 6 to 12 hours, while Orellanine poisoning may take 36 hours to 3 weeks for symptoms to manifest.
The severity of gastrointestinal distress can also vary depending on the type and amount of mushroom consumed. Small quantities of toxic mushrooms typically result in milder symptoms, such as nausea and diarrhoea, which usually do not cause long-term damage. However, ingesting larger amounts or certain species of toxic mushrooms can lead to more severe symptoms, including liver and kidney failure, and even death.
Some of the most common mushrooms associated with gastrointestinal distress include Chlorophyllum molybdites, also known as "greengills" or "backyard mushrooms", and Omphalotus spp., commonly known as "Jack-o-lantern mushrooms". Mushrooms in the Amanita genus, such as Amanita smithiana and Amanita pantherina, are also known to cause gastrointestinal distress, along with other serious symptoms such as kidney failure and disorientation.
If you suspect mushroom poisoning, it is important to seek medical attention immediately, even if you are unsure whether the mushrooms were toxic. Do not wait for symptoms to occur, as prompt treatment can be life-saving in severe cases.
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Cholinergic toxicity
Cholinergic toxidrome may include symptoms such as abdominal cramping, diaphoresis (profuse sweating), salivation, lacrimation, bronchospasm, bronchorrhea, lethargy, urinary frequency, miosis, bradycardia, dizziness, and hypotension. Gastrointestinal symptoms are the most frequently reported, with up to 90% of patients experiencing symptoms similar to gastroenteritis. Cholinergic mushroom poisoning typically has a mild clinical course and a rapid onset time of 30 to 120 minutes. Symptoms usually subside within 24 hours.
While cholinergic mushroom poisoning is usually mild and self-limiting, fatal cases have been reported due to parasympathetic overdrive causing severe hemodynamic compromise. In 2019, no fatalities from cholinergic mushroom poisoning were reported to poison control centers in the United States, but 354 individuals were treated in healthcare facilities, with 8 (2%) suffering a major adverse outcome.
Cholinergic mushroom poisoning can be treated with anticholinergic agents such as atropine or glycopyrrolate.
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Preventing mushroom poisoning
Mushroom poisoning is a serious condition that can have short-term and long-term effects on the body, and in some cases, it can even be fatal. To prevent mushroom poisoning, it is important to take several precautions and be aware of the potential risks associated with consuming wild or unidentified mushrooms. Here are some detailed instructions to help you avoid mushroom poisoning:
Avoid Consuming Wild Mushrooms:
The majority of mushroom poisonings occur due to the consumption of wild mushrooms. It is strongly advised to refrain from picking and eating wild mushrooms, especially if you are unsure about their identity. Wild mushrooms can be highly toxic, and even a small amount can cause severe poisoning. Unless you are an expert in mushroom identification, it is best to avoid consuming any mushrooms that you find in the wild.
Purchase Mushrooms from Reputable Sources:
To minimize the risk of poisoning, it is recommended to purchase mushrooms from reputable sources such as supermarkets, greengrocers, or specialized mushroom suppliers. Commercially cultivated mushrooms undergo rigorous quality control, reducing the likelihood of consuming toxic varieties.
Familiarize Yourself with Mushroom Varieties:
If you intend to forage for wild mushrooms, it is crucial to educate yourself about the different mushroom varieties. Learn to identify both edible and toxic mushroom species, especially those that resemble each other in terms of colour and morphology. Knowing the characteristics of toxic mushrooms can help you avoid accidental ingestion.
Be Cautious with Similar-Looking Mushrooms:
Some toxic mushrooms closely resemble edible ones, making it challenging to distinguish between them. Always exercise caution when encountering mushrooms that look similar to known edible species. Take the time to properly identify the mushroom before consumption. If you are unsure, it is better to err on the side of caution and refrain from eating it.
Cut Suspected Puffballs in Half:
When foraging for puffballs, it is important to cut the fruiting bodies in half. This is because Amanita mushrooms, which are toxic, can be mistaken for puffballs, especially when they are still encased in their universal veil. Cutting them in half will reveal the outline of a developing Amanita, helping you avoid accidental poisoning.
Regularly Check and Remove Mushrooms from Yards:
If you have young children or pets, it is crucial to regularly inspect your yard or garden for mushrooms and remove them promptly. Young children are naturally curious and may put mushrooms in their mouths, leading to accidental poisoning. By eliminating this risk, you can significantly reduce the chances of mushroom poisoning in your household.
Seek Expert Identification:
If you are unsure about the identity of a mushroom, it is best to seek the expertise of mycologists or botanists. They can assist in accurately identifying the mushroom and determining its edibility. Additionally, you can contact local poison control centres or mycology clubs for guidance and support.
Be Wary of Mushrooms Growing in Lawns:
Mushrooms that grow in lawns may have been exposed to pesticides and other lawn-care chemicals. These mushrooms can pose a risk of poisoning, so it is best to avoid consuming them. Always be cautious when encountering mushrooms in areas where chemical treatments are commonly used.
Cooking, Peeling, and Soaking are Not Sufficient:
It is important to note that cooking, peeling, or soaking a mushroom will not eliminate its toxins. Some mushrooms contain toxins that are heat-stable or resistant to these methods. Therefore, it is essential to correctly identify mushrooms before consumption, rather than relying on preparation techniques to remove potential toxins.
Seek Immediate Medical Attention:
If you suspect that you or someone you know has ingested a poisonous mushroom, seek immediate medical attention. Contact your doctor, local poison control centre, or emergency services, depending on the severity of the symptoms. Bring a sample of the mushroom, if possible, to aid in identification and treatment.
Keep the Poison Control Centre Number Handy:
It is a good idea to save the poison control centre number in your phone contacts. In the event of a suspected mushroom poisoning, you can quickly call for assistance and receive guidance on next steps. The poison control centre can provide valuable support and advice.
In summary, preventing mushroom poisoning involves a combination of education, caution, and seeking expert guidance. By following these instructions, you can significantly reduce the risk of accidental mushroom poisoning for yourself and those around you. Remember, it is always better to be safe than sorry when it comes to consuming wild or unidentified mushrooms.
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