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Mushroom Poisoning, Emergency Medicine

Michael E. Nelson and Timothy B. Erickson Reviewed 06/2017
 


Basics

Description

  • Amanitin/phalloidin:

    • Species:

      • Amanita phalloides (“death cap”)

      • Amanita virosa/Amanita verna (“destroying angel”)

      • Galerina marginata, Galerina venenata

    • Mechanism:

      • Cyclopeptide toxins inhibi...

Diagnosis

Signs and Symptoms

  • Amanitin/phalloidin:

    • Nausea

    • Vomiting

    • Abdominal cramps

    • Bloody diarrhea

    • Clinical course:

      • Onset of symptoms delayed 6–36 hr with development of GI symptoms

      • Transient latent phase may...

Treatment

Pre-Hospital

Bring any unconsumed mushrooms or mushroom pieces to hospital to aid in diagnosis: 
  • Refrigerate specimens if possible, place in brown paper bag.

Initial Stabilization/Therapy

  • ABCs

  • Es...

Follow-Up

Disposition

Admission Criteria

  • All symptomatic patients:

    • Protracted vomiting, dehydration, liver or renal toxicity, or seizures

  • Transfer to tertiary medical center for early signs of renal or he...

Pearls and Pitfalls

  • There are old mushroom pickers, and bold mushroom pickers; but there are no old, bold mushroom pickers.

  • Symptoms with late onset (>6 hr) generally indicate more lethal toxins.

  • Lac...

Additional Reading

  • Beuhler  MC, Sasser  HC, Watson  WA. The outcome of North American pediatric unintentional mushroom ingestions with various decontamination treatments: An analysis of 14 years of TE...

Codes

ICD9

988.1 Toxic effect of mushrooms eaten as food 

ICD10

T62.0X1A Toxic effect of ingested mushrooms, accidental, init 

SNOMED

  • 86505009 Toxic effect from eating mushrooms (disorder)

  • 216771005 Acciden...

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