Mushrooms

The incidence of fungal poisoning varies a lot in a global perspective and is related to local habits, economic factors and lifestyle. Among thousands of mushroom species fewer than a hundred are toxic. Most fungal toxins cause mild or moderate poisoning. However, it is the ingestion of a few species of extremely poisonous fungi that define the medical dimension of the problem. Mushroom poisoning is mostly accidental and the result of a mix-up between edible and toxic fungi, but intentional ingestion of psychotropic (‘magic’) mushrooms is also a problem. The most dreaded poisonings are those caused by cytotoxic agents, e.g. amatoxins in death cap and destroying angel (severe gastroenteritis and liver damage) or orellanine in Cortinarius spp. (kidney damage). Dramatic, but rarely lethal, effects are caused by fungi holding neurotoxins like muscarine (Clitocybe and Inocybe spp.), psilocybin (Psilocybe and Panaeolus spp. – ‘magic’ mushrooms), isoxazoles (fly agaric and panther cap) and gyromitrin (false morels). Most poisonous species cause gastroenteritis only. Treatment includes gastrointestinal decontamination and general symptomatic and supportive care. Specific antidotes exist for fungi containing muscarine, gyromitrin and amatoxins.