Mushroom Poisoning: Identification, Diagnosis, and Treatment
Alan H. Hall MD1
David G. Spoerke RPh, MS
Barry H. Rumack MD2
1 Clinical Toxicology Fellow, Rocky Mountain Poison and Drug Center, University of Colorado Health Sciences Center, Denver General Hocpital, Denver and Associate Editor, Poisindex(R) Information System, Rocky Mountain Poison and Drug Center, Denver
2 Professor of pediatrics, University of Colorado Health Sciences Center, and Director, Rocky Mountain Poison and Drug Center, Denver General Hospital, 645 Bannock St, Denver, CO 80204-4507
Mushroom poisoning can cause a wide range of symptoms including gastroenteritis, euphoria or hallucinations, cholinergic or anticholinergic syndromes, disulfiram-like reactions (flushing, anxiety, palpitations, possible hypotension) when the mushrooms are ingested with ethanol, fulminant hepatic failure, seizures, hemolysis, and methemoglobinemia.
More than 5,000 species of wild mushrooms grow in the United States. It is not known what percentage of these mushroom species are potentially toxic. Some species are "toxic" to some individuals but not to others. Species identification can often be difficult, and the percentage of toxic species within genera varies considerably. More than 75% of Amanita species may contain some toxic substance, whereas less than 10% of Morchella species are potentially harmful. The frequency of occurrence of toxic species in a locale also changes the percentage encountered during any collecting foray.
Given the natural curiosity and hand-to-mouth behavior of young children, the desire of many to partake of "natural" foodstuffs, and the interest of some in ingesting "magic mushrooms" for their mind-altering properties, clinicians may easily be faced with the need to treat mush-room-poisoned patients.
In 1984, 4,742 of 5,806 total cases of mushroom exposure reported to the American Assiciation of Poison Control Centers National Data Collection System were in children less than 6 years of age.
