Mushroom poisoning • Symptoms, course & what to do?

Mushroom poisoning is caused by eating poisonous mushrooms. Various mushroom toxins are responsible for the symptoms of poisoning. In most cases, the mushroom pickers accidentally prepare and ingest mushrooms that are harmful to health due to mix-ups or insufficient knowledge. More rarely, mushroom poisoning occurs through conscious consumption of (supposedly) psychoactive mushrooms.

Multiplication tables for mushroom hunting

Forms of mushroom poisoning depending on the level of danger

Depending on how quickly the symptoms of poisoning set in, a distinction is made between mushroom poisoning with a short latency period (15 minutes to six hours) and poisoning with a long latency period (over six hours to several days). If the symptoms appear shortly after eating the mushrooms, the poisoning is usually not organ damaging and therefore not life-threatening. However, the unpleasant symptoms can last for several days.

Poisoning with a long latency period is far more dangerous, as in this case the poison has had a long time to spread throughout the body and attack organs such as the liver and kidneys. These cases need intensive medical treatment to save the lives of those affected. After surviving mushroom poisoning, they often have to live with long-term consequences. As with all poisoning, the extent of symptoms and damage depends on the amount of toxins ingested.

Food poisoning from improperly stored and spoiled mushrooms

In addition to real mushroom poisoning, some people also experience intolerance and allergic reactions when consuming edible mushrooms, which are actually harmless. As a result of improper storage and preparation of mushrooms, bacterial contamination can also lead to the formation of toxins, which lead to symptoms of classic food poisoning.

Anyone who suffers from nausea, diarrhea or vomiting after a mushroom meal should call the emergency doctor (112) immediately or contact the poison control center in their federal state. Under no circumstances should you experiment with medication or home remedies on your own. These may mask or even worsen the poisoning.

Rapid medical diagnosis and therapy can save lives in the case of poisoning. Therefore, if they suspect mushroom poisoning, those affected should go to a hospital immediately and point out their suspicion that they have eaten poisonous mushrooms at the reception desk in the emergency room.

Symptoms of mushroom poisoning

The symptoms of mushroom poisoning can express themselves in very different ways. Because every type of toadstool contains different and sometimes several different toxins.

The list of fungal toxins is long and the chemical structure and mode of action of the harmful substances have not yet been fully explained. For all symptoms that occur after a mushroom meal, mushroom poisoning should therefore always be considered – rapid medical treatment can then save lives.

Poisoning by death cap mushrooms

The most common is Phalloids Syndrome. This type of mushroom poisoning is responsible for 90 percent of all fatal mushroom poisonings. The cause is the highly poisonous so-called amatoxins, which occur in tuber mushrooms, the coniferous wood cap, some other Galerina (Häublinbgs) species, as well as in various parasols. The green cap mushroom in particular looks like a tempting edible mushroom and is often confused with a meadow mushroom due to its external similarity.

Amatoxins (and especially the so-called amanitins) penetrate the body's cells and inhibit their genetic apparatus, so that proteins can no longer be produced for the exchange of information and for one's own metabolism. The affected tissue dies. The cells of the liver are the first to be damaged by the action of toxins due to their high activity. For this reason, amanitin poisoning is usually perceived as a liver disease. The toxicity of the Amanitine is so high that even a green amanita mushroom can lead to fatal poisoning.

The symptoms often appear in several phases, in the meantime the symptoms improve, which is particularly insidious. The first phase after the mushroom meal usually lasts eight to twelve hours (sometimes 48 hours), during which the patients have no symptoms (symptom-free latency). The first signs after that are:

• sudden nausea
• severe, colicky abdominal pain
• Vomit
• watery diarrhea.

This gastrointestinal phase can last for twelve to 24 hours. It can cause shock due to the loss of water and electrolytes. It is triggered by other toxins (so-called phallotoxins), which are also contained in mushrooms in addition to amatoxins.

The symptoms then improve, which laypeople often consider a recovery. In reality, however, the poisoning by the amatoxins continues unstoppable. The toxins mainly attack the liver, which becomes noticeable after a further latency period of about one to two days through symptoms of liver dysfunction. In addition to changes in blood values, jaundice and a pronounced tenderness of the liver can occur. It can also lead to bleeding in the gastrointestinal tract, altered urinary behavior and impaired consciousness.

If left untreated, the patient often dies after a few days due to (multiple) organ failure.

Symptoms of the muscarinic type

The toxin muscarin was isolated from the fly agaric for the first time, although it occurs only in small quantities and is hardly responsible for its toxicity. On the other hand, it can be found in larger quantities in cracked mushrooms and funnels. The poison is built up like a certain messenger substance in the human body, the so-called acetylcholine, and occupies its docking points (receptors). The result is permanent excitation of the affected cells.

The symptoms of poisoning usually begin shortly after eating the mushrooms (a few minutes to a maximum of two hours). The complaints include:

• profuse saliva and tearfulness
• Sweats
• nausea
• Vomit
• Visual disturbances
• slowed pulse

The poison can also narrow the airways, causing asthma-like symptoms with acute shortness of breath. If this is the case, doctors speak of an asthmoid reaction.

Even if the symptoms of poisoning are very threatening and unpleasant, they usually subside without permanent damage. In addition, the deadly nightshade poison atropine is an effective antidote, as it displaces the muscarine from the receptors. An untreated muscarinic poisoning can lead to death from circulatory failure only in very large quantities.

Symptoms of fly agaric and panther mushroom poisoning

The group of the pantherina type includes mainly the fly agaric and its relative, the panther mushroom. Their toxins cause intoxication-like states that were previously used for ritual purposes in some cultures. However, consuming larger amounts can be fatal.

Not all responsible ingredients have been identified yet. The main active ingredient is the so-called ibotenic acid, which breaks down in the dried mushroom or when cooked to form the even more effective substance muscimol. Muscimol can bind to certain cell structures in the human brain and thereby cause various disorders. The panther mushroom has a significantly higher toxicity (toxicity) than the fly agaric.

The symptoms of this mushroom poisoning as pantherina poisoning are initially reminiscent of an alcohol intoxication. Typical are:

The patients lose the feeling for time and space as well as for their own personality.

The characteristics of the intoxication state are crucially dependent on the initial situation. In addition to euphoria, depression, fits of anger and anxiety are also possible.

Especially when consuming larger amounts there is a risk of seizures and confusion (delirium). Most of the time, patients end up falling into a deep sleep that can last ten to 15 hours. After waking up, there are often no memories of the events that were experienced while intoxicated.

Ingesting too much of the toxins can result in a coma or even death from respiratory paralysis.

Psilocybin type: Symptoms of intoxicating mushrooms

The toxins psilocybin and psilocin occur in the so-called magic mushrooms and cause perception disorders, similar to those of the drug LSD. The effect of psilocybin and psilocin is due to their structural similarity to the body's own messenger substance serotonin. Serotonin normally filters the incoming flood of sensory stimuli in the brain. The toxins override this protective mechanism. As a result, the brain can no longer classify the incoming sensory impressions in a meaningful way, resulting in overstimulation and impaired perception.

Physical signs of mushroom poisoning with intoxicating mushrooms include:

• Racing heart
• high blood pressure
• Overheating of the body
• greatly dilated pupils

However, the focus is on the psychological symptoms that can develop depending on the mood of the patient. As a result, both euphoric states of intoxication and massive fears, depression and aggression are possible. The patients experience a changed sense of space, time and body with disturbed sensory perceptions (volume, sounds, play of colors). Disturbances in consciousness and various forms of hallucinations can occur. These can be heard, seen but also felt.

The perception of reality is mostly still there, but sometimes strongly distorted. One therefore speaks of pseudo-hallucinations. The intoxicated state usually lasts six to ten hours.

If there is a certain susceptibility (disposition), the toxins can trigger or intensify psychoses. In addition, so-called flashbacks can occur at a later point in time. All of a sudden, the patient relived the intoxication experience without having consumed the triggering substance again.

Discomfort of the gastrointestinal tract

A variety of mushrooms can lead to what is known as gastrointestinal syndrome when consumed. The symptoms are limited to the gastrointestinal tract and usually disappear on their own after two to three days at the latest. The patients suffer from severe nausea, abdominal pain and vomiting diarrhea. The causative toxins of this heterogeneous group are very diverse. The majority of the poisoning mechanisms have therefore not yet been elucidated in detail.

Even if mushroom poisoning with a short latency period is usually not life-threatening, it should not be underestimated. It should also be borne in mind that different types of mushrooms are often cooked and eaten together, so that mixed poisoning is definitely possible, in which only the quickly occurring symptoms of poisoning are initially considered. All suspected cases should therefore be clarified by a doctor.

Poisoning by spring sallow

The responsible toxin gyromitrin occurs mainly in the spring salmon (can easily be confused with the edible morel) and some (rare) related mushrooms. Gyromitrin is broken down into monemethylhydrazine by boiling or gastric juice. This substance is actually heat-labile and water-soluble, which is why the spring lilac was considered an edible mushroom for a long time when sufficiently cooked (and is still valid in some countries).

In the meantime, however, serious and even fatal poisoning has occurred several times, despite correct preparation. Since monemethylhydrazine is very volatile with a boiling point of 87 degrees Celsius, some of the substance escapes directly during cooking. Inhaling the steam from the boil can lead to poisoning. In the body, the toxin damages the liver and central nervous system.

The symptoms of poisoning often occur in two stages. First of all, gastrointestinal complaints such as abdominal pain, nausea, vomiting and diarrhea occur no earlier than six hours (up to a maximum of 25 hours) after ingestion. Patients feel dull and complain of headaches. The incipient damage to the central nervous system and the resulting symptoms (CNS symptoms) vary in severity in this first phase. For example, you experience restlessness, dilated pupils, and cramps. Often the symptoms subside and simulate a recovery.

However, treacherously, the poisoning progresses in the body. In the second phase, CNS symptoms intensify and the liver is increasingly damaged. These are manifested by symptoms such as jaundice (jaundice), an increase in the concentration of so-called transaminases in the blood and the dissolution of red blood cells (partial hemolysis).

In addition, non-functional hemoglobin, so-called methemoglobin, is increasingly formed, which can no longer deliver oxygen to the tissue. The amount of urine excreted can also be greatly reduced (anuria). Patients can fall into a coma. Death can occur a few days after ingestion of the mushrooms due to circulatory collapse and respiratory failure.

Insidious: Orellanus type with a very long latency period

This type of mushroom poisoning has been observed after consuming various species of Rauhkopf. The substance orellanin, which has a strong kidney-damaging effect, seems to be mainly responsible. However, since orellanin cannot be detected in all cases of poisoning of this type, other, as yet unknown toxins are probably also involved.

What is particularly treacherous about this poisoning syndrome is that the symptoms have a very long latency period of two to 16 days. This circumstance often makes it difficult to assign the disease to the mushroom meal that was long ago.

The first signs are also quite unspecific with general fatigue and headaches. Often, nausea, vomiting, diarrhea and abdominal cramps occur initially. Symptoms of the onset of kidney dysfunction are pain in the lumbar region, severe thirst and a dry mouth with a simultaneous change in urinary behavior. In severe cases, pronounced kidney dysfunction up to and including kidney failure with increasing nausea and nausea.

If left untreated, the diseases are therefore often fatal. However, if the poisoning is recognized and treated in good time, permanent damage can be avoided in many cases.

Mushroom poisoning in combination with alcohol

Symptoms of this mushroom poisoning only occur if alcohol is consumed after the mushroom meal (in the case of larger amounts of alcohol also before the mushroom consumption). Therefore, after consuming various types of ink, it is dangerous to consume alcohol within the next 24 hours, but in exceptional cases also two to five days later.

The substance coprin was isolated from various types of ink as the responsible poison in the Coprinus type. The substance interferes with the breakdown of alcohol in the body, so that certain intermediate products accumulate, which lead to symptoms. The latency period therefore varies with the point in time at which alcohol is consumed. It should be noted that hidden alcohols (for example in medication) can also lead to the poisoning syndrome.

Shortly after drinking alcohol (20 minutes to two hours later), hot flashes and characteristic reddening of the face and neck appear. Other symptoms can include headache, a metallic taste in the mouth, tingling in the arms and legs, dizziness and palpitations. The symptoms usually resolve within one to six hours.

The poisoning is usually not life threatening.

Causes: Only a few mushrooms are life-threatening and toxic

About 150 poisonous mushrooms are known in Europe, but only a few of them can cause life-threatening fungal poisoning. Many of the mushrooms contain toxins that are hazardous to health when raw, but are destroyed by heating (boiling for at least 15 minutes). The correct preparation is therefore of great importance. However, some mushroom poisons have a very stable structure that is not destroyed even by long cooking, so that mushroom poisoning is possible despite cooking. There are even mushroom poisons that work through inhalation of cooking water or only in combination with alcohol.

Each type of toadstool contains different and sometimes even several different toxins. The list of fungal toxins and the symptoms they cause is therefore very long and the chemical structure and mode of action of the harmful substances have not yet been fully explained.

Diagnosing mushroom poisoning: acting quickly is important

If there is a suspicion of mushroom poisoning, a hospital should be visited immediately. This also applies in the event that no symptoms have occurred yet.

The diagnosis of mushroom poisoning is initially based on the symptoms and the statements of the patient or their companion.

Mushroom residues to analyze the poison

In the event of suspicion, it is particularly important to find out as quickly as possible which fungi may have caused the poisoning. Are still Leftovers from the mushroom meal or the incurred Mushroom waste available, they should be given to the doctor for analysis. Also Vomit of the patient can be used for this.

The is of great importance for further diagnostic procedures and therapy Time between eating the mushrooms and the first appearance of symptoms.

Short latency periods usually indicate that the poison has not yet attacked any organs. However, especially with mixed mushroom dishes, there is the possibility that mushrooms with organ-damaging toxins have also been ingested, so a blood test is always carried out and the liver and kidney function carefully monitored. The same applies to poisoning with a long latency period, regardless of whether symptoms are already present or not.

The patients are usually admitted to the hospital for observation and therapy.

Mushroom Poisoning: Prompt Medical Treatment Can Save Lives

The therapy depends on the type of mushroom poisoning. In principle, it is important to get the toxins out of the body and to alleviate the symptoms or avoid serious consequential damage from poisoning.

Autonomous attempts at therapy with home remedies should be avoided in any case in the case of mushroom poisoning. In the worst case, they can obscure or even worsen the course of the disease. Consists after eating mushroom meals the Suspected mushroom poisoning, should be concerned treated quickly by a doctor become. So that the causative fungal toxin can be determined quickly, remains of the collected material, the mushroom meal and, if necessary, vomit should be taken to the clinic.

If there is certainty about the toxins causing the problem, the therapy is targeted towards it. If the symptoms appear very quickly after eating the mushrooms, part of the meal is probably still in the stomach. In this case it can be useful to use the Emptying stomach by vomiting or pumping outto prevent further absorption of the toxins into the blood. However, if the symptoms only appear after a longer latency period, this measure no longer makes sense, as the substances have long since passed the stomach.

Treatment measures against mushroom poisoning

Medicinal charcoal binds toxins in the body and removes them from the food cycle. In many types of poisoning, therefore, 20 to 60 grams of medicinal charcoal can be administered repeatedly.

Basically, it is important to stabilize the patient's circulation and control blood pressure and pulse rate and, if necessary, provide support with medication.

In the case of severe vomiting and watery diarrhea, it is important to balance the fluid and electrolyte balance. If necessary, this is done via an infusion (drip).

Even if not a life-threatening one Mushroom poisoning is available, the patients usually remain in the hospital for a few days for observation.

Severe mushroom poisoning can result in organ failure

If there is poisoning that leads to liver or kidney damage, the therapy focuses on protecting and relieving the affected organ. In very severe cases, a transplantation be the last resort. In the case of one Capsicum mushroom poisoning this measure is indicated and life-saving in up to 30 percent of patients. Due to the lack of donor organs and the acute risk to the patient, artificial liver replacement systems have to be used to bridge the time until the transplant.

Prevent mushroom poisoning: leave mushrooms in doubt!

In general, only mushrooms that can be clearly identified should be consumed. Mushrooms can also spoil during transport, storage and preparation and toxins form.

Even those who think they know mushrooms well can be wrong. Therefore, if you have any doubts about the edibility of the mushroom, it is better to stay in the forest. Because depending on the region, the nature of the soil and the weather conditions, mushrooms can look very different from what you are used to. Ideally, a qualified and certified mushroom expert should confirm the find as edible.

Golden rule: only collect what you know

Anyone who collects mushrooms – whether regularly or only occasionally – should also most important toadstools and their edible doppelgangers know and be able to determine without doubt. So must the fatal one Green death cap mushroom can be clearly distinguished from mushrooms. Other edible mushrooms such as pearl mushrooms, chanterelles or chestnut boletus also have poisonous relatives that mushroom pickers should definitely know.

It is reckless to only read your mushroom knowledge through internet forums or – in some cases outdated – mushroom books. If you want to get started with mushroom picking, you should obtain information from certified mushroom experts and take part in guided mushroom hikes. In addition, the "immigration" of heat-loving poisonous mushrooms, which often look very similar to the local, edible ones, threatens new dangers.

Correct storage and preparation

Improper transport, storage and preparation can create toxins in edible mushrooms. That is why only mushrooms that are in good condition belong in the saucepan. Moldy, old and rotten specimens remain in the forest. The container should be airy, as mushrooms spoil quickly. For the same reason, they should be prepared as quickly as possible. A possible Storage must always be cool and dry to prevent mushroom poisoning.

Only a few types of mushrooms can be eaten raw and fresh. The mushrooms should therefore be heated for at least 15 minutes before consumption. Leftovers from a mushroom meal should also be cooled down quickly, stored in a cool place for a maximum of one day and consumed well reheated.

If, after the meal, the suspicion arises that harmful or poisonous mushrooms may have been consumed, it is important to keep calm and go to the hospital as soon as possible. If mushroom poisoning is suspected, rapid diagnosis and therapy are often life-saving. Therefore should Remnants of the collected mushrooms, Cleaning waste, Leftovers from the prepared meal as well as possibly Vomit be taken to the clinic to determine the specific fungal toxin. #

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