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Toxic Fungi of Western North America
Toxic Fungi of Western
North America
by
Thomas J. Duffy, MD
Pu
blished by MykoWe
(www.m )
b
ykoweb.com
March, 2008 (Web)
August, 2008 (PDF)
2
Toxic Fungi of Western North America
Copyright © 2008 by Thomas J. Duffy & Michael G. Wood
Toxic Fungi of Western North America
3
Contents
Introductory Material
........................................................................................... 7
Dedication ............................................................................................................... 7
Preface .................................................................................................................... 7
Acknowledgements ................................................................................................. 7
An Introduction to Mushrooms & Mushroom Poisoning
.............................. 9
Introduction and collection of specimens .............................................................. 9
General overview of mushroom poisonings ......................................................... 10
Ecology and general anatomy of fungi ................................................................ 11
Description and habitat of
Amanita phalloides
and
Amanita ocreata
.............. 14
History of
Amanita ocreata
and
Amanita phalloides
in the West ..................... 18
The classical history of
Amanita phalloides
and related species ....................... 20
Mushroom poisoning case registry ...................................................................... 21
“Look-Alike” mushrooms...................................................................................... 21
Identification aids ................................................................................................ 24
Guidelines for pot-hunters ................................................................................... 25
Insecticides and other toxic sprays...................................................................... 26
Guide to the identification of mushroom poisoning by symptoms ..................... 27
Onset of symptoms less than 4 hours after ingestion: .................................... 27
Onset of symptoms after 4 hours from time of ingestion: ............................... 28
Group I toxins: Amatoxins
................................................................................. 30
4
Toxic Fungi of Western North America
The amatoxic group .............................................................................................. 30
General description and occurrence ................................................................. 30
The Amanitas .................................................................................................... 30
The Lepiotas ...................................................................................................... 32
The Galerinas .................................................................................................... 35
Conocybe filaris
................................................................................................. 37
Ethnicity and amanitin poisoning ....................................................................... 39
Toxins of
Amanita phalloides
, other amatoxic
Amanita
and amatoxic species in
the genera
Lepiota
,
Galerina
and
Conocybe
........................................................ 41
The Wieland-Meixner qualitative test for amatoxins ......................................... 43
The pathologic picture of amanitins .................................................................... 44
Pregnancy and amanitin poisoning ..................................................................... 48
Fatality rates from selected studies published since 1970 ................................. 48
Evaluation of amanitin treatment ....................................................................... 49
Prognostic indicators for likely fatality ............................................................... 50
The clinical course of amanitin poisoning ........................................................... 51
Detailed treatment of amanitin poisoning .......................................................... 53
Outline and summary of treatment for poisoning by amatoxins ....................... 58
Group II toxins: Ibotenic Acid/Muscimol
........................................................ 60
Isoxazole poisoning from
Amanita muscaria
&
Amanita pantherina
(pantherine
syndrome) .............................................................................................................60
Toxins of the ibotenic acid/muscimol group (pantherine poisoning) .................. 64
Toxic Fungi of Western North America
5
Symptoms of ibotenic/muscimol poisoning (isoxazol poisoning) ........................ 67
Treatment of ibotenic acid/muscimole poisoning ................................................ 69
Group III toxins:
Amanita smithiana
.............................................................. 71
Amanita smithiana
poisoning & unclassified renal/hepatic toxicity ................. 71
Clinical picture, presumed toxin and treatment ................................................ 72
Group IV toxins: Orellanine
.............................................................................. 75
Delayed renal failure with Cortinarius species .................................................. 75
The genus
Cortinarius
in general ........................................................................ 77
Toxins of Cortinarius orellanus ........................................................................... 77
Clinical course and treatment ............................................................................. 79
Group V toxins: Gyromitrin
............................................................................... 80
Gyromitrin group ................................................................................................. 80
Gyromitrin toxins ................................................................................................. 82
The clinical picture of gyromitrin poisoning ....................................................... 83
Treatment of gyromitrin toxicity ......................................................................... 84
Group VI toxins:
Paxillus involutus
................................................................ 86
Autoimmune hemolysis with
Paxillus involutus
................................................ 86
Group VII toxins: Muscarine
............................................................................. 89
The muscarine group toxins ................................................................................ 89
General description and occurrence .................................................................... 90
The clinical picture of muscarine poisoning ........................................................ 94
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