Tox in The Land: Name this Mushroom! Mushrooms & You

Amanita Muscaria

  • AKA Fly agaric & Fly amanita

  • Description: Red/orange cap with white spots

  • Toxins: Ibotenic acid, muscimol, muscarine

  • Clinical findings

    • CNS: CNS depression, agitation, hallucinations

    • GI: Nausea, vomiting, diarrhea

    • Symptoms can vary based on amount of each toxin in the mushroom ingested

  • Treatment

    • Supportive

    • IVF, antiemetics, benzodiazepines

Amanita pantherina

  • AKA Panther cap, false blusher

  • Description: Shiny brown or grey brown cap with white spots

  • Toxins: Ibotenic acid and mucimol

  • Clinical findings:

    • CNS: CNS depression, agitation, hallucinations

    • GI: Nausea, vomiting, diarrhea

    • Symptoms can vary based on amount of each toxin in the mushroom ingested

  • Treatment

    • Supportive

    • IVF, antiemetics, benzodiazepines

Amanita Phalloides

  • AKA Death cap

  • Description: Yellow/green cap, white gills and stem

  • Toxin: Amatoxin

  • Clinical findings: Onset 6-12 hours

    • GI: nausea, diarrhea; hepatotoxic

  • Treatment:

    • NAC

    • Activated charcoal

    • IV Silibinin

    • Transplant

Psilocybin

  • AKA Magic mushrooms

  • Description: Goldish brown cap, halos, bruises when touched

  • Toxin: Psilocybin

  • Clinical findings:

    • Onset 30 min

    • Duration 4-12 hours

    • CV: HTN, tachycardia

    • Neuro: Hallucinations, tachycardia

  • Treatment: Supportive

Clitocybe dealbata

  • AKA iIvory funnel

  • Description: White, flat, wavy margin

  • Toxin: Muscarine

  • Clinical effects:

    • Onset 15-30 min

    • Duration 2-12 hours

    • Symptoms: cholinergic —Increased secretions-GI/respiratory

  • Treatment:

    • Atropine

    • Scopolamine


Corprinopsis atramentaria

  • AKA Inky cap

  • Description: Grey, brown, bell shaped

  • Toxin: Coprine

  • Clinical effects:

    • Onset 30min-2 hours

    • Duration 2-6 hours

    • Symptoms: Disulfiram like reaction — Flushing, headache, tachycardia, anxiety, chest pain

  • Treatment: Supportive

Gyromitra esculenta

  • AKA False morel

  • Description: Red, brown brain

  • Toxin: Gyromitrin

  • Clinical effects

    • Onset 4-10 hours

    • Duration 2-5 days

    • Symptoms:

      • GI: Nausea, vomiting, diarrhea

      • Neuro: Refractory seizures

  • Treatment:

    • Pyridoxine

    • Benzodiazepines

    • Supportive treatment

Tricholoma equestre

  • AKA Yellow knight

  • Description: Yellow-brown cap, pale yellow stem and gills

  • Clinical effects:

    • Onset 24-72 hours

    • Duration 2-3 weeks

    • Symptoms:

      • Fatigue, nausea, vomiting

      • Myalgias

      • Rhabdomyolysis

  • Treatment:

    • IVF

    • Supportive management

POST BY: DR. HALEY WARTMAN, EM PGY3

FACULTY EDITING BY: DR. LAUREN PORTER (Medical Toxicology Faculty)

References

Amanita muscaria: Basic Info. ICEERS. Retrieved March 2023. https://www.iceers.org/amanita-muscaria-basic-info/

Amanita muscaria. North Carolina Extension Gardener Plant Toolbox. Retrieved March 2023. https://plants.ces.ncsu.edu/plants/amanita-muscaria/

Amanita phalloides. First Nature. Retrieved March 2023. https://www.first-nature.com/fungi/amanita-phalloides.php

Bedry R, Baudrimont I, Deffieux G, et al. Wild Mushroom Intoxication as a Cause of Rhabdomyolysis. N Engl J Med. 2001; 345 (11): 798-802.

Fontes K. Tox Cards: Mushrooms. EMdocs.22 Jun 2017. Retrieved March 2023. http://www.emdocs.net/tox-cards-mushrooms/

Gyromitra esculenta, a false morel. BioWeb. Retrieved March 2023. http://bioweb.uwlax.edu/bio203/s2013/hammett-_will/toxicity.htm

Klimaszyk P, Rzymski P. The Yellow Knight Fights Back: Toxicological, Epidemiological, and Survey Studies Defend Edibility of Tricholoma equestre. Toxins (Basel). 2018 10(11): 468.


ToxLauren McCaffertytoxicology, tox, mushrooms, shrooms, medtox