Mushroom Poisoning

Mushroom Poisoning is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Amanitin/phalloidin:
    • Species:
      • Amanita phalloides (“death cap”)
      • Amanita virosa/Amanita verna (“destroying angel”)
      • Galerina marginata, Galerina venenata
    • Mechanism:
      • Cyclopeptide toxins inhibit RNA polymerase 2, which kills GI epithelium, hepatocytes, nephrocytes
  • Gyromitrin:
    • Species:
      • Gyromitra esculenta (“false morels”)
      • Other Gyromitra spp.
    • Mechanism:
      • Gyromitrin hydrolyzed to monomethylhydrazine
      • Inhibits pyridoxal phosphate
      • Results in decreased GABA production
      • Damage to RBCs, hepatocytes, neurons
  • Muscarine:
    • Species:
      • Inocybe (several species)
      • Clitocybe (several species)
      • Boletus sp.
      • Rubinoboletus sp.
    • Mechanism:
      • Muscarine acts like acetylcholine resulting in parasympathomimetic symptoms
  • Coprine:
    • Species:
      • Coprinus atramentarius (“inky caps”)
    • Mechanism:
      • Blocks acetaldehyde dehydrogenase
      • Causes disulfiram-like reaction if mixed with alcohol
  • Ibotenic acid/muscimol:
    • Species:
      • Amanita pantherina (“panther cap”)
      • Amanita muscaria (“fly agaric”)
      • Amanita ibotengutake (Japanese Ringed-Bulb)
    • Mechanism:
      • Ibotenic acid is derivative of glutamate
      • Muscimol is GABA derivative
  • Psilocin/psilocybin:
    • Species:
      • Psilocybe and Panaeolus spp. as well as others
      • Stalks may turn blue upon handling, nonspecific
    • Mechanism:
      • Similar structure to lysergic acid diethylamide, effect serotonin receptor
  • Gastric irritants:
    • Many various mushrooms, including those normally considered edible
  • Orellanine:
    • Species:
      • Cortinarius (several species)
    • Mechanism:
      • Direct renal toxicity
  • Neurovascular toxins
    • Species:
      • Clitocybe amoenolens (Poison Dwarf Bamboo mushroom)
      • Clitocybe acromelalgia
    • Mechanism:
      • Acromelic acids A-E, Kainate analogs, peripheral glutamate receptors
  • Myotoxin
    • Species:
      • Tricholoma equestre (Yellow Knight, “man on horse”)
    • Mechanism unknown, induces rhabdomyolysis

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Basics

Description

  • Amanitin/phalloidin:
    • Species:
      • Amanita phalloides (“death cap”)
      • Amanita virosa/Amanita verna (“destroying angel”)
      • Galerina marginata, Galerina venenata
    • Mechanism:
      • Cyclopeptide toxins inhibit RNA polymerase 2, which kills GI epithelium, hepatocytes, nephrocytes
  • Gyromitrin:
    • Species:
      • Gyromitra esculenta (“false morels”)
      • Other Gyromitra spp.
    • Mechanism:
      • Gyromitrin hydrolyzed to monomethylhydrazine
      • Inhibits pyridoxal phosphate
      • Results in decreased GABA production
      • Damage to RBCs, hepatocytes, neurons
  • Muscarine:
    • Species:
      • Inocybe (several species)
      • Clitocybe (several species)
      • Boletus sp.
      • Rubinoboletus sp.
    • Mechanism:
      • Muscarine acts like acetylcholine resulting in parasympathomimetic symptoms
  • Coprine:
    • Species:
      • Coprinus atramentarius (“inky caps”)
    • Mechanism:
      • Blocks acetaldehyde dehydrogenase
      • Causes disulfiram-like reaction if mixed with alcohol
  • Ibotenic acid/muscimol:
    • Species:
      • Amanita pantherina (“panther cap”)
      • Amanita muscaria (“fly agaric”)
      • Amanita ibotengutake (Japanese Ringed-Bulb)
    • Mechanism:
      • Ibotenic acid is derivative of glutamate
      • Muscimol is GABA derivative
  • Psilocin/psilocybin:
    • Species:
      • Psilocybe and Panaeolus spp. as well as others
      • Stalks may turn blue upon handling, nonspecific
    • Mechanism:
      • Similar structure to lysergic acid diethylamide, effect serotonin receptor
  • Gastric irritants:
    • Many various mushrooms, including those normally considered edible
  • Orellanine:
    • Species:
      • Cortinarius (several species)
    • Mechanism:
      • Direct renal toxicity
  • Neurovascular toxins
    • Species:
      • Clitocybe amoenolens (Poison Dwarf Bamboo mushroom)
      • Clitocybe acromelalgia
    • Mechanism:
      • Acromelic acids A-E, Kainate analogs, peripheral glutamate receptors
  • Myotoxin
    • Species:
      • Tricholoma equestre (Yellow Knight, “man on horse”)
    • Mechanism unknown, induces rhabdomyolysis

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