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Mushroom poisoning occurs in 4 groups: foragers who purposefully harvest mushrooms or plants for food; teenagers and young adults who use mushrooms to get “high”; preschool-age children who accidentally ingest mushrooms while playing outdoors; and, rarely, victims of attempted homicide or suicide.
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Determine if patients ingested only 1 type or multiple types of mushrooms and time elapsed from ingestion to symptoms. Foragers may be able to provide a description of the mushroom. Clinical features of common mushroom poisonings are listed in Table 128-1.
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Diagnosis and Differential
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Most patients that develop GI symptoms within 2 hours of ingestion have a reassuring clinical course and do not develop major organ failure (Table 128-1). An exception to this is Amanita smithiana ingestion, which results in early GI symptoms and delayed renal failure. Mushrooms with potential liver, kidney, and CNS effects are often associated with onset of vomiting that is delayed for 6 or more hours after ingestion. Toxic species include Amanita, Galerina, Gyromitra, and Lepiota. Ingestions may be misdiagnosed as ...