Mushrooms Causing Gastrointestinal Disorders

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This large group of mushrooms accounts by far for the largest number of mushroom poisonings, but fatalities are very rare, possibly absent. In the great majority of cases the toxins involved remain unidentified, and may differ from species to species.

3.9.1 Chlorophyllum molybditis

This mushroom was originally classified in the genus Lepiota, and is also known as Lepiota morgani or Lepiota molybditis (false parasol). It is a species often involved in poisonings in the U.S. and throughout the world, but apparently not in Europe. The attractive mushroom grows in grassland and can be distinguished from edible lepiotas by its greenish spores and greenish gills. The toxin was suggested to be a protein of high molecular weight, composed of monomers of 40 to 60 kDa. Symptoms typically start within one to two hours after ingestion, with profuse vomiting and nausea, followed by diarrhea, intestinal cramps, and sweating. In severe cases symptoms may last up to two to three days. Vomiting and diarrhea can cause significant fluid and electrolyte depletion, which must be balanced. No hepatic or renal sequelae are known. (For a review see Augenstein, 1994.)

3.9.2 Entoloma sinuatum (or lividum)

This mushroom is responsible for a significant number of mushroom poisonings in Europe. Symptoms such as vomiting, abdominal pain, and diarrhea may be seen between thirty minutes and two hours after ingestion. No Entoloma poisonings have been fatal and symptoms disappear within a day or two.

3.9.3 Tricholoma perdidum

Of all mushroom poisonings in two Swiss studies, 20 to 50% were due to this mushroom. One to two hours postingestion the patient may experience abdominal pain, violent vomiting, sweating, diarrhea, and cramping in the calf muscles. Symptoms usually last for two to six hours, but full recovery may take three to six days.

3.9.4 Agaricus xanthodermus

GI reactions have occurred from ingestion of yellow-staining Agaricus species. Agaricus xanthodermus has a strong phenol-like odor and taste, and phenol has indeed been discovered in it and in a number of other Agaricus mushrooms. It is unclear, however, whether phenol or another agent is responsible for the GI upset.

3.9.5 Omphalotus olearius (or illudens)

This mushroom known as Jack O'Lantern, can cause severe gastroenteritis after a latent period of one to three hours, with headache, nausea, sweating, vomiting, abdominal pain, sometimes associated with bitter taste, and a feeling of coldness. It has been argued that these effects may be due to a muscarine-like reaction, but no muscarine has been identified. A sesquiterpene, illudin S, is believed to be at least one of the toxic components.

3.9.6 Lactarius helvus

Lactarius species are 'milk'-containing mushrooms. Poisonous Lactarius are generally found in species with white latex. After eating large quantities of these mushrooms, symptoms such as vomiting, profuse diarrhea, and sweating will occur fifteen minutes to one hour after the meal. The nature of the toxin is unknown.

3.9.7 Ramaria (or Clavaria) pallida

This mushroom has been known to produce gastroenteritis and profuse diarrhea. The toxin responsible has not been identified.

3.9.8 Boletus calopus, B. santanas

GI irritants are the most common toxins in Boletes, particularly in red-spored and yellow-spored species. Muscarine is present in a few species, but too low to be significant. Symptoms are nausea, vomiting, and diarrhea. In more severe cases there may be muscle cramps and circulatory disturbance. Treatment is largely symptomatic, and recovery is usually complete one to two days after ingestion.

3.9.9 Paxillus involutus

Paxillus syndrome is a food allergy, not a true poisoning. As a consequence, some who eat the mushrooms will not develop symptoms. Symptoms may include colic, vomiting, diarrhea, oliguria or anuria, kidney pain, hemoglobi-nuria, and renal failure. A hemagglutination test has been used for confirmation (Bresinsky and Besl, 1990).

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