Mushroom poisoning

Mushroom poisoning


Introduction

3 types  of  mushroom  poisoning is  known:

1. Muscarine  type  (early  mushroom poisoning)

  • Due  to  Inocybe and  related  species.
  • Symptoms  are  due to  muscarinic  action.
  • Drug  of  choice is  atropine.( atropine sulfate, 0.01–0.02 mg/kg/dose IV repeated every 30 minutes until atropinization)

2. Hallucinogenic  type

  • It  is  due to  muscimol  and  other isoxazole  compounds  which  are  present  in  A. muscaria.
  • These  isoxazole  compounds  activate  amino acid,  receptors,  and  block  muscarinic  receptor  in  brain;  and  have hallucinogenic  property.
  • There is  no specific  treatment  and  atropine  is  contraindicated.

Another  hallucinogenic  mushroom  is  Psiloocybe  mexicana  whose active  principal  Psilocybine  is  a tryptaminergic compound.

3. Phalloidin  type  (late  mushroom poisoning)

  • Due  to  peptide  toxin  found  in  A. phalloides  and  Galerina.
  • These  inhibit  RNA  & protein  synthesis.
  • Symptoms  are  due to  damage  to  the  GI mucosa, liver  and kidney.

Treatment:

  • penicillin is  suppportive,  Thiotic  acid  may be  used.
  • For convulsions, diazepam may be given.
  • Hemodialysis may be done.

Fatal dose:2–3 mushrooms.

Fatal period:Usually 24 h.

Diagnosis:

  • Meixner test  (Wieland test) for detection of
  • toxins (D-amanitin) in stools and vomitus.

Postmortem Findings:

  • Inflammation of the mucous membrane of the GIT and fatty degeneration of the liver, kidneys and heart may be found.
  • In case of neurotic symptoms, congestion of the brain and petechial hemorrhages in serous membranes are seen

Exam Important

Drug  of  choice in mushroom poisoning is  atropine.( atropine sulfate, 0.01–0.02 mg/kg/dose IV repeated every 30 minutes until atropinization).

Fatal dose:2–3 mushrooms.

Fatal period:Usually 24 h.

Diagnosis:

  • Meixner test  (Wieland test) for detection of
  • toxins (D-amanitin) in stools and vomitus.

Postmortem Findings:

  • Inflammation of the mucous membrane of the GIT and fatty degeneration of the liver, kidneys and heart may be found.
  • In case of neurotic symptoms, congestion of the brain and petechial hemorrhages in serous membranes are seen
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