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Mushrooms are a common toxic exposure, with an average of 7428 exposures per year from 1999 to 2016, with 62% of cases in children <6 years of age.1 Approximately 40 exposures per year result in major harm, averaging three deaths per year.1 Liver failure is the most common serious harm.1

Fortunately, the majority (86%) of reported mushroom exposures have a benign outcome.1,2 There are no easily recognizable differences between nonpoisonous and poisonous mushrooms. Mushroom toxins are not heat labile and so are not destroyed or deactivated by cooking, canning, freezing, drying, or other means of food preparation.

Depending on the type of mushroom, adverse effects from ingestion range from mild GI symptoms to major cytotoxic effects resulting in organ failure and death. Toxicity varies based on the amount ingested, the age of the mushroom, the season, the geographic location, and the way in which the mushroom was prepared prior to ingestion. One person may show significant effects, whereas others may be asymptomatic after ingesting the same mushroom (Table 220-1). Mushroom toxicity is divided into early toxicity (within 2 hours after ingestion) and delayed toxicity (6 hours to 20 days later).

TABLE 220-1Mushrooms: Symptoms, Toxicity, and Treatment

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