Mushroom poisoning 641982 222299177 2008-06-28T16:13:01Z Harryboyles 754264 Fix date parameter in inline maintenance tag(s) {{Magazine|date=December 2007}} {{dablink|"Poison Mushroom" redirects here. For poison mushrooms in Mario games, see the article [[Mushroom (Mario)]].}} {{seealso|List of deadly fungi}} {{Infobox_Disease | Name = Mushroom poisoning | Image = Mushroom_immatures.jpg | Caption = These emerging mushrooms are too immature to safely identify as edible or toxic. | DiseasesDB = | ICD10 = {{ICD10|T|62|0|t|51}} | ICD9 = {{ICD9|988.1}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = D009145 | }} '''Mushroom poisoning''', also known as '''mycetism''', refers to deleterious effects from ingestion of [[toxic]] substances present in a [[mushroom]]. These symptoms can vary from slight [[Gastrointestinal tract|gastrointestinal]] discomfort to [[death]]. The [[toxin]]s present are [[secondary metabolites]] produced in specific [[biochemical pathways]] in the [[Fungus|fungal]] cells. Mushroom poisoning is usually the result of ingestion of wild mushrooms after misidentification of a toxic mushroom as an edible species. The most common reason for this misidentification is close resemblance in terms of colour and general [[morphology (biology)|morphology]] of the toxic mushrooms species with edible species. Even very experienced wild mushroom gatherers are sometimes poisoned by eating toxic species, despite being well aware of the risks. To prevent mushroom poisoning, mushroom gatherers need to be very intimately familiar with the mushrooms they intend to collect, including knowledge of the toxic species that look similar to these edible species. Other considerations regard methods of preparation and toxicity of some fungal species that appears to vary with geographic location, raising the potential of mushroom poisoning due to local toxicity of a correctly identified species. ==Folk traditions== There are many folk traditions concerning the defining features of poisonous mushrooms<ref>{{cite web|url=http://www.calpoison.org/public/mushrooms.html|title=California Poison Action Line: Mushrooms|accessdate=2008-02-18}}</ref><ref>{{cite book|title=Edible and Poisonous Mushrooms of the World|author=Ian Robert Hall|date=2003|publisher=Timber Press|isbn=0881925861|page=p. 103}}</ref>. Unfortunately there are no general identifiers for poisonous mushrooms, and so such traditions are unreliable guides. For example, while some highly coloured mushrooms such as [[fly agaric]] are indeed poisonous, other strongly coloured mushrooms are harmless. Other highly toxic mushrooms, such as the appropriately named [[destroying angel]], are of unremarkable white colour. Lack of snail or insect infestation is also an unreliable identifier, since fungi that are harmless to invertebrates can still be toxic to humans; the [[death cap]], for instance, is often infested by insect [[larvae]]. Likewise, poisonous mushrooms neither blacken [[silverware]] during cooking, nor necessarily smell or taste unpleasant. Importantly, many [[mycotoxin|fungal toxins]] are not particularly [[thermostability|sensitive to heat]] and so are not broken down during cooking. ==Guidelines== Persons who gather wild mushrooms should follow some practical guidelines (see [[mushroom hunting]]). In particular, they should not eat any mushroom they cannot positively identify; not allow small children to gather mushrooms for consumption; or mix known edibles with questionable species while gathering, since mushroom parts could break off and be confused with edible species. Cooking mushrooms before eating is a safer practice, as only very few species can be eaten raw. [[Alcohol]] consumption should be limited when eating wild mushrooms positively identified as edible, but not consumed before{{Fact|date=February 2008}}. Some species, most notably certain ink caps (''[[Coprinopsis atramentaria]]'') can cause an adverse reaction when eaten with alcohol. Portions of species that a person has not eaten before should be kept small (no more than 150 grams per person at one meal {{Fact|date=January 2008}}). In some regions in Europe, mushrooms are not eaten at all; in other regions, such as Finland, Scandinavia and Russia, which traditionally have suffered from food shortage in winters, strong local knowledge on edible mushrooms exists and mushrooms form a remarkable part of cuisine. Yet many mushroom enthusiasts limit their pickings to only easily recognizable mushrooms, such as chanterelles and boletes, and leave agarics unpicked. [[False morel]] (''Gyromitra esculenta'') is often called the "[[fugu]] of the Finnish cuisine", since it is deadly poisonous when raw, but rarely causes poisoning if properly prepared (although its edibility is still a matter of dispute). Specimens that look similar to edibles at one geographic location may be deadly in another region and should not be collected without good knowledge of the local [[biota]]. For instance, ''[[Cantharellus]]'' is often picked in [[Scandinavia]] where no risk of confusing this mushroom with toxic species exists. {{Fact|date=January 2008}} However, in North America, this ground-dwelling mushroom has been known to be mistaken for the wood-decaying Jack O'Lantern mushroom (''[[Omphalotus olearius]]''), which may grow from the ground if there is buried wood present. Note also recent reports of confusion between ''[[Volvariella speciosa]]'', a popular edible species in Asia, and ''[[Amanita phalloides]]'', a deadly poisonous species in North America and Europe. Very young [[Sporocarp (fungi)|fruiting bodies]] of [[destroying angel]] (''Amanita virosa'') mushrooms resemble the well-known [[champignon]], or [[Agaricus bisporus|button mushroom]], a mushroom widely sold in markets. Similarities between these two species lead to a few deaths every decade in [[Scandinavia]] alone {{Fact|date=January 2008}}. Cases of fatal mushroom poisoning are relatively common in Europe, but less so in North America ;{{Fact|date=January 2008}} this may be related to the use of folklore rather than detailed knowledge in Europe, whereas North American mushroom collectors tend to refer often to authoritative reference works. {{Fact|date=January 2008}}{{or|date=February 2008}} ==Symptoms== Poisonous mushrooms contain a variety of different toxins that can differ markedly in toxicity (see list below). So symptoms of mushroom poisoning may vary from gastric upset to life-threatening organ failure resulting in death. Serious symptoms do not always occur immediately after eating; often not until the toxin attacks the kidney or liver, from minutes to hours later, or, as is the case for [[Alpha-amanitin|α-amanitin]] poisoning, not until days after consumption. Symptoms may not appear for days and thus delay lifesaving treatment. Symptoms of mushroom poisoning vary depending on the toxins involved and typically include: * [[Fatigue (medical)|Fatigue]] * [[Headache]] * [[Dizziness]] * Cold sweat * [[Hallucinations]] * [[Vomiting]] * Sharp [[abdominal pain]]s * [[Jaundice]] * Severe [[diarrhea]] * Blurred vision Some mushrooms contain less toxic compounds and, therefore, are not severely poisonous. Poisonings by these mushrooms may respond well to treatment. However, certain types of mushrooms, such as the Amanitas, contain very potent toxins and are very poisonous; so even if symptoms are treated promptly [[mortality]] is high. With some toxins, death can occur in a week or a few days. Although a liver or kidney transplant may save some patients with complete organ failure, in many cases there are no organs available. Patients who are hospitalized and given aggressive support therapy almost immediately after ingestion of amanitin-containing mushrooms have a mortality rate of only 10%, whereas those admitted 60 or more hours after ingestion have a 50-90% mortality rate (http://www.cfsan.fda.gov/~mow/table2.html) and (http://vm.cfsan.fda.gov/~mow/Chap40.html) More detail on the exact symptoms associated with different toxins can be found below. ==Toxins== {{seealso|Category:Mycotoxins}}. *[[alpha-amanitin]] (deadly) &ndash; principal toxin in genus ''Amanita'' *[[bolesatine]] (found in ''[[Boletus satanas]]'') *[[coprine]] (only poisonous with alcohol) *[[orellanine]] (deadly) &ndash; principal toxin in genus ''Cortinarius'' *[[gyromitrin]] (deadly) *[[muscarine]] (sometimes deadly) *[[arabitol]] (causes gastrointestinal irritation in some people) ==Poisonous species== {{seealso|List of deadly fungi}} Three of the most lethal mushrooms belong to the genus ''[[Amanita]]'': the [[death cap]] (''A. phalloides'') and [[destroying angel]]s (''A. virosa'', and ''A. bisporiga''); and two are from the genus ''[[Cortinarius]]'': the [[deadly webcap]] (''C. rubellus''), and the [[fool's webcap]] (''C. orellanus''). These species cause the greatest number of fatalities. Poisoning by ''Amanita phalloides'' is characterized by a delay of between 6 and 24 hours from the time of ingestion to the onset of symptoms. During this time, the cells of the [[kidney]]s and [[liver]] are attacked. There is no antidote for poisoning and mortality is between 10 and 15 percent.<ref name ="benjamin95">{{cite journal |author=Benjamin DR |title=Amatoxin syndrome |pages=198–214}} in: {{cite book |title=Mushrooms: poisons and panaceas — a handbook for naturalists, mycologists and physicians |publisher=New York: WH Freeman and Company |year=1995}}</ref> There have been some recorded studies suggesting that ''Silybum marianum'' or [[Silybum marianum|blessed milk thistle]] protect the liver from aminita toxins and promote regrowth of damaged cells, including a study in which 60 patients exposed to death cap poison were given 20 mg/kg of milk thistle seeds per day within 48 hours of consuming the deadly mushrooms. None of the patients died.<ref name ="thist1">{{cite journal |author=Blake V |title=Milk thistle |pages=706–707}} in: {{cite book |title=PDR For Herbal Medicines |publisher=New York: Thomson Healthcare |year=2004}}</ref> Many species of [[Galerina]], [[Lepiota]], and [[Conocybe]] contain also lethal amounts of [[amatoxin]]s. The following species may cause great discomfort, but are less often lethal. * ''[[Amanita muscaria]]'' (fly agaric) &ndash; poisonings rare, possibly because its unique and obvious appearance make it easily identifiable; it is known for its use as an [[entheogen]], and it is now known that the toxins convert to psychoactives upon drying. * ''[[Amanita pantherina]]'' (panther mushroom) &ndash; contains similar toxins as ''A. muscaria'', but in higher quantities. * ''[[Amanita muscaria|Amanita muscaria'' var. ''regalis]]'' &ndash; symptoms generally mild. * ''[[Chlorophyllum molybdites]]'' (greengills) &ndash; causes intense gastrointestinal upset. * ''[[Entoloma]]'' (pinkgills) &ndash; highly poisonous, such as livid entoloma (''[[Entoloma sinuatum]]''), ''[[Entoloma rhodopolium]]'', and ''[[Entoloma nidorosum]]''. First symptoms appear after 20 minutes to 4 hours. * ''[[Galerina]]'' &ndash; some species contain [[alpha-amanitin]]. * Many ''[[Inocybe]]'' species such as ''[[Inocybe fastigiata]]'' and ''[[Inocybe geophylla]]'' contain [[muscarine]], while ''[[Inocybe erubescens]]'' is the only one known to have caused death. * Some white ''[[Clitocybe]]'', including ''[[Clitocybe rivulosa|C. rivulosa]]'' and ''[[Clitocybe dealbata|C. dealbata]]'' &ndash; first symptoms after 15 to 20 minutes * Tiger Tricholoma '' ([[Tricholoma tigrinum]])'' &ndash; no lasting effect after 2 to 6 hours of great pain. * Man-on-horseback ''[[Tricholoma equestre]]'' &ndash; until recently thought edible and good, can lead to [[rhabdomyolysis]] after repeated consumption. * [[Sulfur tuft]] (''Hypholoma fasciculare'') &ndash; poisoning may be serious * ''[[Omphalotus olearius]]'' &ndash; severe * False morel (''[[Gyromitra esculenta]]'') &ndash; deadly poisonous when raw; usually OK cooked, and delicious if correctly prepared. * [[Brown roll-rim]] (''Paxillus'' ''involutus'') &ndash; once thought edible, but now found to destroy [[red blood cell]]s with regular or long-term consumption. * Devil's bolete (''[[Boletus satanas]]'') * [[Purple bolete]] (''B. rhodoxanthus'') * ''[[Conocybe filaris]]'' &ndash; contains [[amatoxin]]s, sometimes mistaken for ''[[Psilocybe]]''. * Some species of ''[[Agrocybe]]'' contain a deadly amount of toxins. * ''[[Hebeloma crustuliniforme]]'' (known as Poison pie or Fairy cakes) &ndash; can cause gastrointestinal symptoms such as nausea and vomiting. ==Other causes of poisoning== Mushrooms may be rendered poisonous by insecticides or herbicides sprayed on lawns or reserves. At least one author recommends never picking them in non-natural landscapes for this reason.{{fact|date=February 2008}} Also, mushrooms are sometimes contaminated by concentrating pollutants, such as heavy metals or radioactive material (see [[Chernobyl disaster effects]]). ==Famous poisonings== *Roman Emperor [[Claudius]] is said to have been murdered by being fed the [[death cap]] mushroom. However this story appears some two centuries after the events, and it is even debatable whether Claudius was murdered at all.<ref>{{cite journal|title=The death of Claudius|author=V J Marmion and T E J Wiedemann|journal=Journal of the Royal Society of Medicine|volume=95|pages=260–261|year=2002|url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1279685#ref8|doi=10.1258/jrsm.95.5.260|pmid=11983773}}</ref> *[[Holy Roman Emperor Charles VI]], [[Pope Clement VII]], and Tsaritsa [[Natalia Naryshkina]] are believed to have died from [[Amanita_phalloides#Notable victims|eating the death cap mushroom]]. ==References== {{reflist}} ==External links== * [http://americanmushrooms.com/toxic.htm Poisonous American Mushrooms - AmericanMushrooms.com] * [http://vm.cfsan.fda.gov/~mow/chap40.html Mushroom toxins] from the Center for Food Safety & Applied Nutrition * [http://www3.sympatico.ca/ross.fraser/Richard2.htm Poisonous mushrooms: microscopic identification in cooked specimens] from medical mycologist R.C. Summerbell * [http://www.namyco.org/toxicology/poisoning.html Mushroom poisoning Syndromes] from the [[North American Mycological Association]] * [http://www.sph.umich.edu/~kwcee/mpcr/ Mushroom poisoning Case Registry] (North America) from the [[North American Mycological Association]] {{Poisoning and toxicity}} [[Category:Poisonous mushrooms| ]] [[Category:Toxicology]] [[Category:Mycotoxins]] [[cs:Otrava houbami]] [[de:Pilzvergiftung]] [[it:Avvelenamento da funghi]] [[lt:Nuodingieji grybai]] [[sv:Svampförgiftning]] [[tr:Mantar zehirleri]]