Revision as of 15:37, 8 February 2021 by ClaireLewis (→ManagementDiaz JH. Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med. 2005 Feb. 33(2):427-36.)
- Also known as "brain fungi"
- Fruit in the spring and early summer
- Frequently mistaken for morel mushrooms
- Inhibits formation of Vitamin B6 and GABA via hydrazine metabolite (similar to isoniazid toxicity)
- GI upset, fatigue, muscle cramps
- Liver failure
- Can present with refractory seizures due to GABA deficiency
- Hemolysis usually mild
- Rarely methemoglobinemia
Mushroom toxicity by Type
|Crotinarius||Orellanine||Delayed renal failure|
- Blood sugar
- CBC with differential
- LDH, haptoglobin, reticulocyte
- MetHb level
- Urine drug screen
- Supportive care
- Dextrose boluses/infusions
- High dose pyridoxine for refractory seizures (5g IV initially) 
- Avoid phenobarbital, especially in liver failure
- Methylene blue for severe methemoglobinemia
- Folinic acid (leucovorin) supplementation (hydrazines inhibit MTHF production)
- Liver transplant for refractory hepatic failure
- Brozen R et al. Gyromitra Mushroom Toxicity. Apr 14, 2015. http://emedicine.medscape.com/article/817931-treatment#showall.
- Tomková J, Ondra P, Válka I. Simultaneous determination of mushroom toxins α-amanitin, β-amanitin and muscarine in human urine by solid-phase extraction and ultra-high-performance liquid chromatography coupled with ultra-high-resolution TOF mass spectrometry. Forensic Sci Int. 2015 Jun. 251:209-13.
- Diaz JH. Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med. 2005 Feb. 33(2):427-36.
- Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med. 2005;28(2):175.