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2.  Identify different kinds of mushroom that has toxin;  Explain the effects of these toxins in our body;  Characterize the mushroom from its appearance. END

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8. Another term for mushroom poisoning. This refers to harmful effects from ingestion of toxic substances present in a mushroom. MAIN MENU END

9. These symptoms can vary from slight gastrointestinal discomfort to death. MAIN MENU END

10. The toxins present are secondary metabolites produced in specific biochemical pathways in the fungal cells MAIN MENU END

11. Fungi that are harmless to invertebrates can still be toxic to humans; the death cap, for instance, is often infested by insect larvae T he fly agaric, usually bright red to orange and/or yellow, is narcotic and hallucinogenic, there have been no reported human deaths; the deadly destroying angel, in contrast, is an unremarkable white. BACK MAIN MENU END

12. People who have eaten the deadly Amanitas reported that the mushrooms tasted quite good. While it is true that some otherwise inedible species can be rendered safe by special preparation, many toxic species cannot be made toxin-free. BACK MAIN MENU END

13. A number of Laotian refugees were hospitalized after eating mushrooms deemed safe by this folklore rule and this cost at least one person her life The shape of the mushroom cap does not correlate with presence or absence of mushroom toxins, so this is not a reliable method to distinguish between edible and poisonous species BACK MAIN MENU END

15. Cap : Shape, Surface and Margins

16. Gills : Gills are described by the attachment pattern to the stalk and by spacing, thickness, depth and forking pattern

17. Stem/Stipe : Stipe features include size, color, color changes, shape, position, structure, and surface characteristics

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19. Of the many thousands of mushroom species in the world, only 32 have been associated with fatalities, and an additional 52 have been identified as containing significant toxins. By far the majority of mushroom poisonings are not fatal, but the majority of fatal poisonings are attributable to the Amanita phalloides mushroom PROCEED MAIN back END

20. A majority of these cases are due to "mistaken identity." One way this can happen is that the victim attempts to apply folk knowledge from one geographic area to another PROCEED MAIN back END

22. Mistaken from Coprinuscomatus when immature BACK MAIN END

23. Puffball, an edible puffball mushroom, which closely resembles the immature Amanitas. MAIN MENU END

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25. Foragers are encouraged to always cut the fruiting bodies of suspected puffballs in half, as this will reveal the outline of a developing amanita should it be present within the structure. MAIN MENU END

26. often implicated due to its preference for growing in lawns BACK MAIN END

27. C.molybdites causes severe gastrointestinal upset but is not considered deadly poisonous. MAIN MENU END

28. C.molybdites causes severe gastrointestinal upset but is not considered deadly poisonous. MAIN MENU END

29. C.molybdites causes severe gastrointestinal upset but is not considered deadly poisonous. MAIN MENU END

30. A majority of mushroom poisonings in general are the result of small children, especially toddlers in the "grazing" stage, ingesting mushrooms found in the lawn. MAIN MENU END

31. They are sometimes mistaken for chanterelles BACK MAIN END

32. Omphalotus ssp., "Jack-o-lantern mushrooms," are another cause of sometimes significant toxicity MAIN MENU END

33. Both are bright orange and fruit at the same time of year MAIN MENU END

34. Omphalotus grows on wood and has true gills rather than the veins of a Cantharellus. MAIN MENU END

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36. disulfiram-like compound which is harmless unless ingested within a few days of ingesting alcohol BACK MAIN END

37. It inhibits aldehyde dehydrogenase, an enzyme required for breaking down alcohol. MAIN MENU END

38. Thus the symptoms of toxicity are similar to being "hung over" – flushing, headache, nausea, palpitations, and in severe cases, trouble breathing MAIN MENU END

39. Effects, Symptoms, treatments What are the effects of eating those mushrooms? BACK NEXT MENU END

40. Group I - Cyclopeptide-containing Mushroom Most difficult to treat. 95% of all fatality due to mushroom poisoning Species include Amanita phalloides, A verna, A virosa, Gallerina Autumnalis Toxins include amanitins and phallotoxin which inhibit RNA polymerase II Toxin is stable to cooking, pickling, salting and is not hydrolyzed by digestion

41. Group I - Cyclopeptide-containing Mushroom

45. Amatoxin Clinical Effects : Delay of 6 to 12 hours before initial symptoms is common Phase 1: Severe Gastroenteritis- profuse watery diarrhoea, nausea, vomiting, thirst, Phase 2: transient improvement in symptoms – Latent period of web being lasting 1 to 5 days Phase 3: Recurrence symptoms, manifested with hepatic, renal toxicity, seizures, coma and death

46. Amatoxins - Treatment : Toxin elimination via repeat dose charcoal Supportive care with fluids, electrolytes Penicillin G may displace amanitin from plasma binding sites 1 million Unit/kg/d Thioctic acid Silymarin compete for membrane transport Liver Transplant Forced diuresis, hemodialysis, plasmapheresis- – Not useful

47. Group II Monomethylhydrazine containing Mushrooms : Gyromitra esculenta, G californica Brain like appearance Gyromitrin: Chelate with pyridoxal phosphate- disrupt GABA function Clinical Effects: long latent period of 6 to 12 hours followed by vomiting, watery diarrhea, abdominal pain, weakness and headache. Severe cases notable for jaundice, hyperreflexia, vertigo, loss of muscle coordination, seizures and coma Recovery in 2 to 6 days

48. Group II Monomethylhydrazine containing Mushrooms :

49. Gyromitra esculenta

50. Treatment Standard decontamination measures For seizures, Pyridoxine at 25mg/kg in 15 to 30 minutes IV. Group II Monomethylhydrazine containing Mushrooms :

51. Group III- Muscarine containing: Clitocybe dealbata, Omphalotus olearius Toxin is muscarine which stimulates postganglion parasympathic fibers Omphalotus olearius

52. Group III- Muscarine containing:

55. Muscarine Clinical Effects: Onset within 30 to 120 minutes Clinical Feature: like OP Poisoning Recovery in 6 to 24 hours

56. Muscarine Treatment : Standard decontamination methods In symptomatic patients – Atropine 1mg to 2mg for adults – and children 0 to 2 years.2 mg 3 to 4 years.3 mg 5 to 10 years.4mg

57. Group IV – Coprine-containing Mushrooms : Coprinus atramentarius “Inky caps” Toxin is coprine, The metabolite of which inhibits aldehyde dehydrogenase Ingestion is asymptomatic unless ethanol is consumed in the following 2 hours to 5 days – Disulfiram like effect

59. Coprinus atramentarius

60. Coprine Treatment : Decontamination Symptomatic treatment – B-blockers or sedatives for anxiety and tachycardia Fluids for hypotension

61. Group V - Muscimol/Ibotenic Acid- containing Mushrooms : Amanita Muscaria, Amanita Pantherina, Amanita Gemmata Toxin is Ibotenic acid which is metabolized to Muscimol Muscimol is a false neurotransmitter which stimulates GABA receptors and usually results in anticholinergic symptoms

62. Ibotenic acid Muscimol

63. Amanita gemmata

64. Clinical Effects : Onset within 30 to 90 minutes, most marked at 2 to 3 hours Drowsiness, confusion resembling alcohol intoxication, dizziness, ataxia, euphoria, muscle cramps and spasms, delirium, visual disturbances, hallucinations Vomiting is rare Deep sleep or coma terminates the episode which usually lasts from 4 to 8 hours

65. Musicmol/Ibotenic Acid Treatment : Standard decontamination measures Support airway and hemodynamics with standard measures With life threatening anticholinergic signs, consider physostigmine.5 to 2 mg slow IVP over 5 minutes

66. Group VI - Psilocybin containing Mushrooms: Psilocybe caerulescens, Panaeolus, Gymnopolis “Magic mushrooms” Toxins are Psilocybin and its metabolite psilocin Effects are serotonin and norepinephrine mediated Effects like LSD

68. Psilocybe caerulescens

69. Psilocybin Clinical Effects : Onset of symptoms within 30 to 60 minutes, occasionally as late as 3 hours Symptoms include hallucination, impaired judgement, hyperkinesis, laughter, vertigo, ataxia, muscle weakness and drowsiness

70. Psilocybin Treatment : Decontamination not recommended as this may increase agitation Rest and reassurance in a dark, quiet room Consider benzodiazepines for severe anxiety

71. Group VII - GI Irritants : Largest group with a diverse type of mushrooms (little brown mushrooms) Chlorophyllum molybdites, Agaricus Xanthodermis, Russula Emetica No specific toxins identified Most mushrooms cause more symptoms when eaten raw Onset of symptoms within 30 minutes to 2 hours after ingestion

72. Chlorophyllum molybdites

73. GI Irritants Treatment : Standard decontamination measures Beware of antiemetics and antidiarrheals as these may have unpredictable interactions with mushroom toxins

74. Group VIII- Orelline & Orellanine-containing Mushrooms : Cortinarius species - over 1000 in the US Causes severe renal tubular damage resulting in reduced GFR, decreased absorption of water/NA/K, proteinuria, glucosuria

76. Cortinarius armillatus

77. Orellanine Clinical Effects : Initial mild gastroenteritis Long latent period of 36 hours to 21 days Symptoms include severe thirst, abdominal or flank pain, chills and fever Progresses to acute renal failure. Chronic failure occurs in 50% of cases Recovery takes weeks to months

78. Orellanine Treatment : Standard decontamination Hemodialysis Renal transplant Steroids, hemoperfusion, and forced diuresis do not improve outcome

79. Take the Test END

82. by some accounts, may have died of mushroom poisoning around ~479 BCE,though this claim has not been universally accepted PROCEEDMENU BACK END

84. said to have been murdered by being fed the death cap mushroom. However this story first appeared some two centuries after the events, and it is even debatable whether Claudius was murdered at all. PROCEEDMENU BACK END

86. died in Danzig on 14 August 1701 from accidentally eating poisonous mushrooms. PROCEEDMENU BACK END

88. The best-selling author Nicholas Evans (The Horse Whisperer) was poisoned after eating Cortinariusspeciosissimus PROCEEDMENU BACK END

89. Mushroom hunting is a true sport: The fungi do have an equal chance to win. If we are correct in our identification, at very best we win a tasty side-dish, or an optimally seasoned main course. On the other hand, if we are not correct, we win repeated trips to the head, maybe a trip to the emergency room, and in the extreme, a trip to the mortuary.

90. MAIN BACK END Thank you for listening!