Mushrooms are well known human diet from ancient which have both beneficial and harmful effects . Some of the mushrooms are known for their nutritional and therapeutical uses whereas some other are known for their toxicity. Different substances belonging to mushroom poisons are already identified and are related to different signs and symptoms. Show carcinogenicity, alterations in respirations and cardiac rates, renal failure, rhabdomyolysis (breaking of muscle cells) and other effects are toxicity symptoms of various species including edible and therapeutic ones

2. Background
 Mushrooms are well known human diet from ancient which have both
beneficial and harmful effects .
 Some of the mushrooms are known for their nutritional and therapeutical
uses whereas some other are known for their toxicity.
 Different substances belonging to mushroom poisons are already identified
and are related to different signs and symptoms.
 Show carcinogenicity, alterations in respirations and cardiac rates, renal
failure, rhabdomyolysis (breaking of muscle cells) and other effects are
toxicity symptoms of various species including edible and therapeutic ones
About 1,40,000 species of mushrooms have been identified with about 2000
being considered safe for human consumption and about 700 have therapeutic
properties.

3. Some myths about mushroom in Nepal
 Poisonous mushrooms discolor silver coins during cooking; edible
mushrooms do not.
 Mushrooms eaten by cats, dogs, and monkeys are always safe.
 Mushrooms eaten by snails or insects are considered safe.
 Poisonous mushrooms will lose their poison when cooked with some
vinegar.
 Mushrooms lose their poison when cooked with timur.
 Mushrooms having a fruity smell are safe to eat.
 Mushrooms with bitter, acrid, or pungent taste are poisonous.
 Smooth-capped mushrooms are edible.

4. Poisonous Mushrooms
Amanita Clitocybe Cortinarius
Gyromitra Psilocybe

5.  Well known for the presence of mainly amatoxins.
 Some species also contain phalloin, phalloidin, phallisin, phallacidin,
phallacin and phallisacin, virotoxin .
Fig: Amanita pantherina

6. Toxic Effects
Phallotoxin causes alternations of enterocytes cellular membrane.
Amatoxin inhibits protein synthesis at transcriptional level within
enterocytes, hepatocytes and proximal renal tubular cells.
After the ingestion of this mushroom, it causes necrosis of liver cells with
mortality rates ranging from about 10-20%.
Some reports have shown that this mushroom causes hallucinogenic effect
due to the presence of ibotenic acid.
Symptoms
Motor depression Ataxia (incoordination of muscular movement),
Changes in mood Precipitation and feelings
Dizziness Gastrointestinal disturbances
Drowsiness (sleepy) Muscle twitching.

7. Treatments
 Cholinesterase inhibitors as they counteract the effects of poisoning.
Includes detoxification, careful monitoring and liver transplantation in severe
case.
Saline solution should be given to control thirst.
Nitroglycerine and strychnia frequently given upto the limit of tolerance are
of great value. Milk is mild antidote.
Atropin may be of use as a stimulant.

8. Fig: Clitocybe spp.
Toxic effects
Caused by acromelic acid (ACRO) which has two isomers- ACRO-A and
ACRO-B. ACRO-A has very powerful excitatory action on rat.
Some of the species are poisonous due to the presence of muscarine in their
chemical composition.

9. Symptoms of intoxifications
 The patients show paresthesia (abnormal sensation) of the toes and finger
followed by paroxysmal (time to time) burning pain notably at night.
A sensation of heat, numbness, odema and local erythema (abnormal
awareness of feeling) are associated with cries.
Approximately after 15 minutes to 2 hours of ingestion of this mushroom,
patient can present gastrointestinal problems, miosis, hypersecretion and
bradycardia (slower heart beat) in severe cases.
Treatments
 Atropine can be administered.

10.  Comprises between 2000-3000 species of mushrooms
Fig: Cortimarius smithii
Toxic effects
 Nephrotoxic due to the presence of the cyclopeptide orellanine.
Also the oxidation of orellanine in renal tissue may accumulate quinone
compounds which bind covalently with biological structures leading to cell
damage

11. Symptoms of intoxification
 The symptoms of this species appear between 2-20 days after ingestion.
 Delayed acute tubulopathy (damage kindney tubules) that can progress to
chronic renal insufficiency.
 Initially people experience nausea, vomiting and abdominal pain followed by
intense thirst, chills, polyuria or oliguria and possibly anuria.
Treatment
 Hemodialysis (blood purification) can be done for recreational purposes.
 Saline solution can be given for thirst.

12.  Attractive to hunters and gournets due to their taste.
Some species contain well known toxins like gyromitrin whereas some of
them are nontoxic.
Fig: Gyromitra spp.

13. Toxic effects
They are contained with gyromitrin.
Intoxication occurs due to false cooking method.
Symptoms of intoxication
 Symptoms are seen from 8-12 hours after ingestion.
Most common symptoms includes gastrointestinal (vomiting and diarrhea),
neurological , liver damage and haemolysis.
The other effects of gyromitrin include carcinogenesis and hepatic problems.
Treatments
 It consists of monitoring the symptoms and administrating Vitamin B6
intravenously considering that gyromitrin inactivates this vitamin.

14. Fig: Psilocybe spp
Toxic effects
 Species of Psilocybe are known due to their psychedelic effects caused by
psilocybin.
Common psylocibin containing mushrooms are : P. semilanceata, P.
mexicana, P. bohemica, P. cubensis and P. baeocistis

15. Symptoms of intoxications
 Occurs 30 minutes after ingestion of fresh or dried mushroom with anxiety,
nausea, vertigo and asthenia.
 Neurosensorial symptoms consists of visual problems, disorientation, motor
incoordination .
Sympathom imetic symptoms consists of mydriasis (pupil effects),
tachycardia (faster heart rate) and hypertension.
In children, hyperthermia, seizures and comma may be present.
Treatments
 Recovery is completed after 4-12 hours of ingestion.
The need of hospitalization is rare and in exceptional cases myocardial
infarction (stops blood supply to heart) may occur in adult patients.

16. Conclusion
 Day-to-day, number of intoxications is reported mainly due to
misidentification of species.
Hazardous toxins are present in these species and are able to cause different
syndromes that can be fatal depending on the amount ingested.
Accidental ingestion of mushrooms is difficult to avoid especially in places
where eating wild species is common.
Proper identification is important to avoid accidents and the identification of
symptoms and signs of intoxication as soon as possible enables the success of
treatment.
Intoxications caused by commonly consumed mushrooms and also the edible
mushrooms must be carefully studied.