Mushrooms, some are yummy, some are psychedelic, some are lethal: I wouldn’t know the difference.

Ingestion of Amanita phalloides is responsible for a majority of mushroom-related deaths worldwide. Amatoxins, the principal toxic alkaloids found in these fungi, cause cell injury by halting protein synthesis. A possible antidote licensed in most of Europe, intravenous silibinin, is undergoing evaluation by clinical trial in the United States.

In December 2016, 14 cases of Amanita phalloides poisoning were identified by the California Poison Control System (CPCS) among persons who had consumed foraged wild mushrooms. In the past few years before this outbreak, CPCS only received reports of a few mushroom poisoning cases per year. All patients in this outbreak had gastrointestinal manifestations of intoxication leading to dehydration and hepatotoxicity. Three patients received liver transplants; all patients recovered, although one (a child) had permanent neurologic impairment.

Wild-picked mushrooms should be evaluated by a trained mycologist before ingestion. Inexperienced foragers should be strongly discouraged from eating any wild mushrooms. Health care providers should be aware of the potential for toxicity after wild mushroom ingestion, that gastrointestinal symptoms mimicking viral gastroenteritis can occur after ingestion and slowly progress to potentially fatal hepatotoxicity, and should contact the local poison center for reporting and assistance with management of these patients.

Amanita phalloides Mushroom Poisonings- Northern California, December 2016

MMWR, Weekly, June 2, 2017, 66(21); 549-553, Kathy T. Vo, MD; Martha E. Montgomery, MD; S. Todd Mitchell, MD; Pieter H. Scheerlinck, MD; Daniel K. Colby, MD; Kathryn H. Meier, PharmD; Susan Kim-Katz, PharmD; Ilene B. Anderson, PharmD; Steven R. Offerman, MD; Kent R. Olson, MD; Craig G. Smollin, MD

https://www.cdc.gov/mmwr/volumes/66/wr/mm6621a1.htm?s_cid=mm6621a1_e

Backyard mushrooms nearly deadly for Connecticut family

It was a dish made from backyard mushrooms that sent a family of four to the hospital and a combination treatment of charcoal and an experimental drug that helped save them.

CTnow.com reports the Newington family’s harrowing tale began Thursday when Shah Noor, 40, picked some mushrooms from their backyard. She cooked them with onions, garlic and green chili peppers for dinner that night. Everyone in the family agreed that it was a tasty meal.

But early Friday morning, Noor’s husband Musarat Ullah, 59, and their daughter, Aiman Bibi, 21, had severe stomach pains and went to St. Francis Hospital and Medical Center in Hartford. There, Dr. Danyal Ibrahim, director of toxicology, urged Ullah to call home to make sure everyone else was OK.

“When I called, I heard this hue and cry,” he said. His wife was vomiting and his other daughter, Wafa Guloona, 24, was on the floor holding her stomach. Guloona managed to drive herself and her mother to the hospital, stopping twice to throw up.

After asking what they had eaten recently, it didn’t take long for Ibrahim to focus on the mushrooms. The mushrooms were of the species Amanita bisporigera, common in the northeast. The white mushrooms are perfectly nice looking, but they’re also known as the “destroying angel” and ingesting them can be deadly.

In many cases, the symptoms — severe vomiting, diarrhea and nausea — show up within six hours. That’s actually the better of the two outcomes, and it is what happened to Ullah and Bibi. Delayed symptoms, the kind that affected Noor and Guloona, can be more dangerous. In that case, the toxins from the mushroom are more likely to attack the liver directly.

By late Friday, all four were in the hospital’s emergency department being treated with a combination of IV fluids to restore electrolytes, a charcoal solution that absorbs the toxins and a drug known as N-Acetylcysteine, which helps restore damaged liver cells.

Melbourne woman critical after eating mushrooms

A Melbourne woman is critically ill after eating a toxic death cap mushroom.

Six months after a similar outbreak in a Canberra restaurant killed two and sickened one, Australian health authorities are again warning people not to pick their own mushrooms as recent weather conditions have created the ideal environment for the poisonous fungi.

Austin Hospital emergency department director Dr Fergus Kerr said death cap mushroom poisoning is particularly hard to detect as the more severe symptoms may not appear until a day or two after ingestion.

He said poisoning by death cap mushrooms had a mortality rate of about 50 per cent and urged people to only eat commercially farmed mushrooms.