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General Reference ⬇

Ann IM 1979;90:332; Med Let 1984;26:67

Pathophys and Cause ⬆ ⬇

Cause:

Potentially Fatal (PF) Types: Amanita sp, Galerina sp

Usually Nonfatal (NF) Types:Amanita sp,etc

Pathophys:

PF: Cyclopeptides

NF: GI irritants, muscarinics, et al.

Epidemiology ⬆ ⬇

Ingestion

Signs and Symptoms ⬆ ⬇

Sx:

PF: Onset in 6-20 h; gi sx initially, transient improvement then potentially fatal liver and renal failure

NF: Onset in min, <8 h maximum; hallucinations, Antabuse-like sx; sympathetic/parasympathetic sx; gi sx

Course ⬆ ⬇

PF: Severe, 40-80% fatal

NF: Usually benign

Complications ⬆ ⬇

PF: Renal and hepatic failure

NF: Volume depletion, aspiration of vomitus

Treatment ⬆

Rx:PF: Consult poison control. Acetylcysteine, penicillin, silibinin, cimetidine?

Ipecac; and activated charcoal even late may help if in enterohepatic circulation