Mushrooms are a common toxic exposure, with >8600 poisonous mushroom exposures and five deaths reported to poison control centers in 2004.1 More than 77% of these ingestions were unintentional, with >50% occurring in children <6 years of age. Fortunately, the majority of reported mushroom exposures have a benign outcome.2,3 The most important factor in preventing mushroom poisoning is to avoid eating wild mushrooms. 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 may also vary 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. Individuals also vary in their response to any given mushroom ingestion, so that one person may show significant effects whereas others may be asymptomatic after ingesting the same mushroom (Table 214-1).

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Table 214-1 Mushrooms: Symptoms, Toxicity, and Treatment 

Mushroom toxicity is divided into early toxicity (within 2 hours after ingestion) and delayed toxicity (6 hours to 20 days later). In general, if toxicity begins within 2 hours of ingestion of a mushroom, the clinical course will be benign. If symptoms begin ≥6 hours after ingestion, the clinical course will be more serious and potentially fatal. Nearly all fatalities ...

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