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Identify different kinds of mushroom
that has toxin;
 Explain the effects of these toxins in our
body;
 Characterize the mushroom from its
appearance.
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Another term for
mushroom poisoning.
This refers to harmful
effects from ingestion
of toxic substances
present in
a mushroom.
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These symptoms
can vary from
slight
gastrointestinal
discomfort
to death.
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The toxins present
are secondary
metabolites produced
in specific
biochemical
pathways in the fungal
cells
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Cap : Shape, Surface and Margins
Gills :
• Gills are described by the attachment pattern to the stalk
and by spacing, thickness, depth and forking pattern
Stem/Stipe :
• Stipe features include size, color, color changes,
shape, position, structure, and surface
characteristics
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Of the many thousands of mushroom species
in the world, only 32 have been associated
with fatalities, and an additional 52 have been
identified as containing significant toxins. By
far the majority of mushroom poisonings are
not fatal, but the majority of fatal poisonings
are attributable to the Amanita
phalloides mushroom
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A majority of these cases are due
to "mistaken identity." One way
this can happen is that the victim
attempts to apply folk knowledge
from one geographic area to
another
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Mistaken from
Coprinuscomatus
when immature
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Puffball, an edible
puffball mushroom,
which closely
resembles the
immature Amanitas.
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Foragers are encouraged to
always cut the fruiting bodies
of suspected puffballs in half,
as this will reveal the outline
of a developing amanita
should it be present within the
structure.
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often implicated
due to its
preference for
growing in lawns
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C.molybdites causes
severe
gastrointestinal
upset but is not
considered deadly
poisonous.
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C.molybdites causes
severe
gastrointestinal
upset but is not
considered deadly
poisonous.
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C.molybdites causes
severe
gastrointestinal
upset but is not
considered deadly
poisonous.
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A majority of mushroom
poisonings in general are
the result of small children,
especially toddlers in the
"grazing" stage, ingesting
mushrooms found in the
lawn.
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They are sometimes
mistaken
for chanterelles
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Omphalotus ssp.,
"Jack-o-lantern
mushrooms," are
another cause of
sometimes
significant toxicity
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Both are bright
orange and fruit
at the same
time of year
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Omphalotus grows
on wood and has
true gills rather than
the veins of
a Cantharellus.
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disulfiram-like compound
which is harmless unless
ingested within a few
days of ingesting alcohol
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It inhibits aldehyde
dehydrogenase, an
enzyme required for
breaking
down alcohol.
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Thus the symptoms of
toxicity are similar to
being "hung over" –
flushing, headache,
nausea, palpitations, and
in severe cases, trouble
breathing
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What are the
effects of
eating those
mushrooms?
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Effects, Symptoms,
treatments
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Group I - Cyclopeptide-containing Mushroom
• Most difficult to treat.
• 95% of all fatality due to mushroom poisoning
• Species include Amanita phalloides, A verna, A virosa,
Gallerina Autumnalis
• Toxins include amanitins and phallotoxin which inhibit RNA
polymerase II
• Toxin is stable to cooking, pickling, salting and is not
hydrolyzed by digestion
Group I - Cyclopeptide-containing Mushroom
Group I - Cyclopeptide-containing Mushroom
Amatoxin Clinical Effects :
• Delay of 6 to 12 hours before initial symptoms is
common
• Phase 1: Severe Gastroenteritis- profuse watery
diarrhoea, nausea, vomiting, thirst,
• Phase 2: transient improvement in symptoms
– Latent period of web being lasting 1 to 5 days
• Phase 3: Recurrence symptoms, manifested with
hepatic, renal toxicity, seizures, coma and death
Amatoxins - Treatment :
• Toxin elimination via repeat dose charcoal
• Supportive care with fluids, electrolytes
• Penicillin G may displace amanitin from plasma
binding sites 1 million Unit/kg/d
• Thioctic acid
• Silymarin compete for membrane transport
• Liver Transplant
• Forced diuresis, hemodialysis, plasmapheresis– Not useful
Group II Monomethylhydrazine containing
Mushrooms :
• Gyromitra esculenta, G californica
• Brain like appearance
• Gyromitrin: Chelate with pyridoxal phosphate- disrupt
GABA function
• Clinical Effects: long latent period of 6 to 12 hours
followed by vomiting, watery diarrhea, abdominal pain,
weakness and headache.
• Severe cases notable for jaundice, hyperreflexia, vertigo,
loss of muscle coordination, seizures and coma
• Recovery in 2 to 6 days
Group II Monomethylhydrazine containing
Mushrooms :
Gyromitra esculenta
Group II Monomethylhydrazine
containing Mushrooms :
Treatment
• Standard decontamination
measures
• For seizures, Pyridoxine at
25mg/kg in 15 to 30 minutes IV.
Group III- Muscarine containing:
• Clitocybe dealbata, Omphalotus olearius
• Toxin is muscarine which stimulates
postganglion parasympathic fibers
Omphalotus olearius
Group III- Muscarine containing:
Group III- Muscarine containing:
Group III- Muscarine containing:
Muscarine Clinical Effects:
• Onset within 30 to 120
minutes
• Clinical Feature: like OP
Poisoning
• Recovery in 6 to 24 hours
Muscarine Treatment :
• Standard decontamination methods
• In symptomatic patients
–Atropine 1mg to 2mg for adults
–and children
• 0 to 2 years .2 mg
• 3 to 4 years .3 mg
• 5 to 10 years .4mg
Group IV – Coprine-containing Mushrooms :
• Coprinus atramentarius “Inky caps”
• Toxin is coprine,
• The metabolite of which inhibits aldehyde
dehydrogenase
• Ingestion is asymptomatic unless ethanol is
consumed in the following 2 hours to 5 days
– Disulfiram like effect
Coprinus atramentarius
Coprine Treatment :
• Decontamination
• Symptomatic treatment
–B-blockers or sedatives for anxiety and
tachycardia
• Fluids for hypotension
Group V - Muscimol/Ibotenic Acidcontaining Mushrooms :
• Amanita Muscaria, Amanita Pantherina,
Amanita Gemmata
• Toxin is Ibotenic acid which is metabolized to
Muscimol
• Muscimol is a false neurotransmitter which
stimulates GABA receptors and usually results
in anticholinergic symptoms
Ibotenic acid
Muscimol
Amanita gemmata
Clinical Effects :
• Onset within 30 to 90 minutes, most marked at 2
to 3 hours
• Drowsiness, confusion resembling alcohol
intoxication, dizziness, ataxia, euphoria, muscle
cramps and spasms, delirium, visual disturbances,
hallucinations
• Vomiting is rare
• Deep sleep or coma terminates the episode which
usually lasts from 4 to 8 hours
Musicmol/Ibotenic Acid Treatment :
• Standard decontamination measures
• Support airway and hemodynamics with
standard measures
• With life threatening anticholinergic
signs, consider physostigmine .5 to 2 mg
slow IVP over 5 minutes
Group VI - Psilocybin containing Mushrooms:
• Psilocybe caerulescens, Panaeolus,
Gymnopolis
• “Magic mushrooms”
• Toxins are Psilocybin and its metabolite
psilocin
• Effects are serotonin and norepinephrine
mediated
• Effects like LSD
Psilocybe caerulescens
Psilocybin Clinical Effects :
• Onset of symptoms within 30 to 60
minutes, occasionally as late as 3 hours
• Symptoms include hallucination,
impaired judgement, hyperkinesis,
laughter, vertigo, ataxia, muscle
weakness and drowsiness
Psilocybin Treatment :
• Decontamination not recommended as
this may increase agitation
• Rest and reassurance in a dark, quiet
room
• Consider benzodiazepines for severe
anxiety
Group VII - GI Irritants :
• Largest group with a diverse type of mushrooms
(little brown mushrooms)
• Chlorophyllum molybdites, Agaricus
Xanthodermis, Russula Emetica
• No specific toxins identified
• Most mushrooms cause more symptoms when
eaten raw
• Onset of symptoms within 30 minutes to 2 hours
after ingestion
Chlorophyllum molybdites
GI Irritants Treatment :
• Standard decontamination measures
• Beware of antiemetics and
antidiarrheals as these may have
unpredictable interactions with
mushroom toxins
Group VIII- Orelline & Orellanine-containing
Mushrooms :
• Cortinarius species - over 1000 in the US
• Causes severe renal tubular damage
resulting in reduced GFR, decreased
absorption of water/NA/K, proteinuria,
glucosuria
Cortinarius armillatus
Orellanine Clinical Effects :
• Initial mild gastroenteritis
• Long latent period of 36 hours to 21 days
• Symptoms include severe thirst, abdominal or
flank pain, chills and fever
• Progresses to acute renal failure.
• Chronic failure occurs in 50% of cases
• Recovery takes weeks to months
Orellanine Treatment :
• Standard decontamination
• Hemodialysis
• Renal transplant
• Steroids, hemoperfusion, and
forced diuresis do not improve
outcome
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by some accounts, may have
died of mushroom poisoning
around ~479 BCE,though this
claim has not been universally
accepted
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said to have been murdered by being
fed the death cap mushroom.
However this story first appeared
some two centuries after the events,
and it is even debatable whether
Claudius was murdered at all.
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died in Danzig on 14
August 1701 from
accidentally eating
poisonous mushrooms.
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The best-selling author Nicholas
Evans (The Horse Whisperer) was
poisoned after
eating Cortinariusspeciosissimus
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Mushroom hunting is a true sport: The
fungi do have an equal chance to win. If
we are correct in our identification, at
very best we win a tasty side-dish, or an
optimally seasoned main course. On the
other hand, if we are not correct, we
win repeated trips to the head, maybe a
trip to the emergency room, and in the
extreme, a trip to the mortuary .
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Thank you for
listening! 
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