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PresentsMushroom Toxin

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OBJECTIVES

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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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CausesEffectsPoisonings

tiozonpadua Pastor

Mushroom

Objectives

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TOXIC

Visitor!

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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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Fungi that are harmless to invertebrates can still be toxic to humans; the death cap, for instance, is often infested by insect larvae

The fly agaric, usually bright red to orange and/or yellow, is narcotic and hallucinogenic, there have been no reported human deaths; the deadly destroying angel, in contrast, is an unremarkable white.

Insects vs. mushrooms

No to brightly colored

FOLK TRADITIONS

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People who have eaten the deadly Amanitas reported that the mushrooms tasted 

quite good.While it is true that some otherwise inedible species can be rendered safe by special preparation, many toxic species cannot be made toxin-free.

Taste bad

Just cook it!

FOLK TRADITIONS

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A number of Laotian 

refugees were hospitalized after eating mushrooms 

deemed safe by this 

folklore rule and this 

cost at least one person her life

The shape of the mushroom cap does not correlate with presence or absence of mushroom toxins, so this is not a reliable method to distinguish between edible and poisonous species

If it is red

Pointed vs. Flat-rounded

FOLK TRADITIONS

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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

Causes Effects

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CausesOf 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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CausesA 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 PROCEED

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Jack-o-Lantern

C.molybdite

s Coprine

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Amanitas

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Amanitas

DescriptionMistaken from

Coprinuscomatus when immature

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Puffball, an edible puffball mushroom, which closely resembles the immature Amanitas.

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Spot the diff.!Back Next

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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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Chlorophyllummolybdites

Sourceoften 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.

C.Molybdites

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C.molybdites causes severe

gastrointestinal upset but is not

considered deadly poisonous.

C.Molybdites

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C.molybdites causes severe

gastrointestinal upset but is not

considered deadly poisonous.

C.Molybdites

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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.

C.Molybdites

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Jack-o-Lantern

DescriptionThey 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

Jack-o-lanter n

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Omphalotus grows on wood and has

true gills rather than the veins of

a Cantharellus.

Jack-o-lanter n

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Spot the diff!

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Coprine

Sourcedisulfiram-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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Effects, Symptoms, treatments

What are the effects of eating

those mushrooms

?The effects

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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

Treatment • Standard decontamination

measures • For seizures, Pyridoxine at

25mg/kg in 15 to 30 minutes IV.

Group II Monomethylhydrazine containing Mushrooms :

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 Acid-containing 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

Who are the famous people

poisoned by mushroom?

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Daniel Farenheit

’sParents

EmperorClaudius

NicholasEvansBack

Famous Poisonings

Buddha

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Siddartha GautamaBuddha

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Buddhaby some accounts, may have died of mushroom poisoning around ~479 BCE,though this claim has not been universally

acceptedPROCEEDMENU

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Emperor Claudius

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Emperor Claudiussaid 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.PROCEEDMENU

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Daniel Farenheit’s

Parents

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Daniel Farenheit’s parents

died in Danzig on 14 August 1701 from accidentally eating

poisonous mushrooms.PROCEEDMENU

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Nicholas Evans

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Nicholas EvansThe 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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