Adventure Doc
keeping you healthy for life's adventures
Erik McLaughlin MD, MPH
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DON'T EAT
Pileus or Cap
The Field Guide to Wilderness Medicine groups the study of mushroom poisonings very well. I will follow their lead and group the 4 types of mushroom poisonings the same way. There are 4 main types of toxins involved with mushroom ingestion.
Gills
Stem or Stipe
The toxins can cause a problem in one of four ways: GI (gastro-intestinal), Neuro (nervous), Disulfiram like reactions or with Protoplasmic protein reactions.
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GI toxic mushrooms
LINKS/ LIBRARY
GI toxic mushrooms include Chlorophyllum Molybdites species and cause diarrhea within 2 hours of ingestion. The diarrhea usually lasts around 10 hours. Bloody stools and abdominal cramping may occur. Treat the patient with oral fluids and rehydrate them. Immodium (loperamide) may help.
PRODUCT REVIEWS
Omphalotus Olearius
Chlorophyllum Molybdites
Neurotoxic mushrooms
Neurotoxic mushrooms can be broken down into 2 classes, hallucinogenic and non-hallucinogenic. The hallucinogenic mushrooms are in the Psilocybe family. The hallucinations generally last about 5 hours. These mushrooms can cause seizures in children. If there is an ingestion and a person becomes agitated or seizes, they can be managed with a benzodiazepine or haloperidol. The species Amanita Muscaria or A. Pantherina species can cause muscarinic symptoms such as SLUD (salivation, lacrimation, urination and diarrhea), as well as stomach cramps, bradycardia and respiritory secretions that may clog the airway. Fortunately, the symptoms only last about 6-10 hours and respond well to atropine.
Psilocybe
Amanita Muscaria
Amanita Pantherina
Disulfiram like reactions
Disulfiram like reactions are onyl a problem when the mushroom is ingested and alcohol is drunk during or afterwards. The name "disulfiram like reaction" come from the medicine disulfiram (antabuse) that is used to treat alcoholism. When a person takes the medicine or ingests the mushroom and have alcohol in their system, they get an "instant hang-over". Headache, nausea/vomiting and flushing can occur. The "Inky Cap" mushroom can cause these reactions and there is no real treatment. Offer fluids and supportive care, the symptoms last about 5 hours and the reaction can occur as late as 72 hours between alcohol and mushroom ingestion.
Coprinus Inky Cap
Protoplasmic poisonous mushrooms
Protoplasmic poisonous mushrooms include the Amanita Phalloides (death cap) and the Gyromitra species. Gyromitra can cause reactions, on average, of 10 hours after ingestion but may take up to 2 days! Liver failure results and may last for several days. Nausea/vomiting and cramping may also occur, initially. The Death Cap can cause GI problems such as vomiting/diarrhea and then hepatic failure 2-3 days after ingestion. Unlike the Gyromitra toxin, activated charcoal works well here. Penicillin and milk thistle (silibinin) are also used in treatment.
Amanita Phalloides
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