Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android

There are thousands of mushroom species that cause a variety of toxic effects. The most dangerous species of mushrooms are Amanita phalloides and related species, which contain potent cytotoxins (amatoxins). Ingestion of even a portion of one amatoxin-containing mushroom may be sufficient to cause death.

The characteristic pathologic finding in fatalities from amatoxin-containing mushroom poisoning is acute massive necrosis of the liver.


Amatoxin-containing mushrooms typically cause a delayed onset (8–12 hours after ingestion) of severe abdominal cramps, vomiting, and profuse diarrhea, followed in 1–2 days by AKI, hepatic necrosis, and hepatic encephalopathy. Cooking the mushrooms does not prevent poisoning.

Monomethylhydrazine poisoning (Gyromitra and Helvella species) is more common following ingestion of uncooked mushrooms, as the toxin is water-soluble. Vomiting, diarrhea, hepatic necrosis, convulsions, coma, and hemolysis may occur after a latent period of 8–12 hours.

The clinical effects of these and other mushrooms are described in eTable 38–2.

eTable 38–2.Poisonous mushrooms (listed in alphabetical order).

1. Muscarinic type

(Inocybe and Clitocybe species.) Vomiting, diarrhea, bradycardia, hypotension, salivation, miosis, bronchospasm, and lacrimation occur shortly after ingestion. Cardiac arrhythmias may occur. Fatalities are rare.

2. Anticholinergic type

(Eg, Amanita muscaria, Amanita pantherina.) This type causes a variety of symptoms that may be atropine-like, including excitement, delirium, flushed skin, dilated pupils, and muscular jerking tremors, beginning 1–2 hours after ingestion. Fatalities are rare.

3. GI irritant type

(Eg, Boletus, Cantharellus.) Nausea, vomiting, and diarrhea occur shortly after ingestion. Fatalities are rare.

4. Disulfiram type

(Coprinus species.) Disulfiram-like sensitivity to alcohol may persist for several days. ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.