Mushroom poisoning

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