Management of mushroom poisoning
- Timothy J Wiegand, MD, DABAM, FACMT, FAACT
Timothy J Wiegand, MD, DABAM, FACMT, FAACT
- Director of Medical Toxicology and Toxicology Consult Service
- Associate Clinical Professor of Emergency Medicine
- URMC and Strong Memorial Hospital
- Section Editors
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Stephen J Traub, MD
Stephen J Traub, MD
- Section Editor — Toxicology
- Associate Professor of Emergency Medicine
- Mayo Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Ingestion of potentially poisonous mushrooms occurs frequently, but serious toxicity is uncommon. There are 12 groups of identified mushroom toxins with 14 described clinical syndromes (table 1). Defining which clinical syndrome predominates, initiating general supportive care, and administering any specific treatments for that syndrome are the key steps in the initial management for mushroom ingestion [1,2].
The general management of mushroom poisoning is reviewed here. The clinical manifestations and diagnosis of mushroom poisoning, and the diagnosis and treatment of poisoning caused by mushrooms containing potentially lethal cyclopeptide toxins (eg, amatoxin) and by Amanita smithiana are discussed in greater detail separately. (See "Clinical manifestations and evaluation of mushroom poisoning" and "Amanita smithiana mushroom poisoning" and "Amatoxin-containing mushroom poisoning (eg, Amanita phalloides): Clinical manifestations, diagnosis, and treatment".)
AMATOXIN-CONTAINING MUSHROOM POISONING
Management of amatoxin-containing mushroom poisoning is covered in greater detail separately. (See 'General management' below.)
A regional poison control center should be contacted to discuss likely mushroom species ingested based upon clinical findings, identification of any mushrooms available for analysis, and treatment of specific toxic effects. Most poison control centers maintain active call lists of mycologists who are knowledgeable concerning local prevalence of mushroom genera and species and can assist in mushroom identification. To obtain emergent consultation with a medical toxicologist, call the United States Poison Control Network at 1-800-222-1222, or access the World Health Organization's list of international poison centers (www.who.int/gho/phe/chemical_safety/poisons_centres/en/index.html).
Supportive care and gastrointestinal decontamination with activated charcoal suffice for proper management of most patients with mushroom poisoning .To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- AMATOXIN-CONTAINING MUSHROOM POISONING
- GENERAL MANAGEMENT
- Supportive care
- - Vomiting and diarrhea
- - Agitation, delirium, and/or hallucinations
- - Seizures
- - Cholinergic excess
- - Rhabdomyolysis
- - Liver failure
- - Renal failure
- - Erythromelalgia
- Shitake dermatitis
- Gastrointestinal decontamination
- Elimination enhancement
- ADDITIONAL RESOURCES
- SUMMARY AND RECOMMENDATIONS