Amanita Muscaria Poisoning (Fly Agaric Fung Caus Tox Effct)


Presentation

Skin
Flushing
  • A second reason to consider eating fly agaric is because it is a large mushroom that, as I saw on the Central Coast, can flush in huge numbers.[honest-food.net]
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    • Eyes
    Blurred Vision
    • You may notice (on higher doses), slightly blurred vision, watery eyes and/or a bit of a runny nose. One will begin to feel increasingly relaxed. At this point it is important to lie down in a area where you will not be disturbed and sleep.[shroomery.org]
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    • psychiatrical
    Agitation
    • They key to treating these patients is good supportive care with benzodiazepines as needed for agitation.[thepoisonreview.com]
    • If the patient has seizures or profound neuromuscular agitation, a serum CK and UA to look for rhabdomyolysis may be indicated. TREATMENT Treatment is primarily supportive.[uconnemig.wordpress.com]
    • Clinical findings Patient becomes drowsy 20 to 90 minutes after ingestion, then manic/agitated; in children, seizures may occur. Management Supportive, drugs for seizures.[medical-dictionary.thefreedictionary.com]
    • Origin: USA, NC Distribution: Throughout NC Poison Part: Mushroom Poison Delivery Mode: Ingestion Symptoms: Patient appears to be intoxicated, hallucinations, drowsiness, vomiting, nausea, stomach pains, diarrhea, muscle spasms, hypotension, agitation[plants.ces.ncsu.edu]
    • In cases of serious poisoning it causes a delirium , similar in effect to anticholinergic poisoning it is characterised by bouts of marked agitation with confusion, hallucinations, and irritability followed by periods of central nervous system depression[thepoisondiaries.tumblr.com]
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    • cardiovascular
    Tachycardia
    • Physical examination revealed tachycardia (pulse 127/min) along with mitosis and warm, dry skin. He subsequently developed seizure activity and increased oropharyngeal and respiratory secretions.[thepoisonreview.com]
    • Fever, hematuria, tachycardia, hypotension, rapid volume depletion, and fluid and electrolyte imbalance also may be present. POISONOUS PRINCIPLES : A. muscaria. The toxins are choline, muscarine, and muscaridine. The LD 50 i.v. in mice is 0.23mg/kg.[research.vet.upenn.edu]
    • There are generally not marked changes in vital signs, but tachycardia and bradycardia have occasionally been reported. In severe ingestions, tonic-clonic seizures and coma have been reported.[uconnemig.wordpress.com]
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    • musculoskeletal
    Muscle Twitch
    • Its symptoms after oral intake are described by Richard Schultzes and Albert Hofmann as confusion, disoreantation in situation and time perception, disturbance of visual function and hearing, muscle twitching, weariness, fatigue and sleep.[magic-mushrooms.net]
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    • gastrointestinal
    Abdominal Pain
    • After a minimum period of 6 hours, an explosive, watery diarrhoea, abdominal pain and vomiting starts. There is a high risk of life-threatening liver damage within 2 - 3 days.[helsenorge.no]
    • GI symptoms including abdominal pain, nausea/vomiting and diarrhea are common. Uncommonly, muscarinic symptoms including salivation and lacrimation occur.[uconnemig.wordpress.com]
    • They begin as sudden, severe abdominal pain, vomiting, and diarrhea. Blood, mucus, and undigested food are present in vomitus and stool. Thirst, anuria, prostration, and restlessness are also present.[research.vet.upenn.edu]
    • If symptoms such as vomiting, diarrhea, and abdominal pain begin 5 hours or more after ingestion, mushrooms that can cause potentially life-threatening or severe toxicity (eg, A phalloides or Cortinarius spp) should be considered (see Presentation).[emedicine.medscape.com]
    Abdominal Cramps
    • Eventually she’ll suffer from abdominal cramps, vomiting, and severely dehydrating diarrhea. This delay means her symptoms might not be associated with mushrooms, and she may be diagnosed with a more benign illness like stomach flu.[slate.com]
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    • respiratoric
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    • neurologic
    Confusion
    • There has been a great deal of confusing, contradictory and incorrect information published about the toxicity of Amanita muscaria and A. pantherina.[erowid.org]
    • Even trained mycologists may confuse toxic varieties with nonpoisonous or edible ones.[research.vet.upenn.edu]
    • Symptoms of ibotenic/muscimol poisoning (isoxazol poisoning) The initial symptoms of ibotenic acid poisoning are drowsiness, nausea and occasionally vomiting, usually followed an hour later with a group of central nervous system symptoms: confusion, mild[mykoweb.com]
    • Some varieties of A. muscaria can be confused with poisonous ones. Amanita muscaria has an atypical mechanism of action.[psychonautwiki.org]
    • Even very experienced mushroom hunters aware of both the historical confusion and the death cap’s resemblance to edible fungi have been poisoned by Amanita phalloides .[slate.com]
    Agitation
    • They key to treating these patients is good supportive care with benzodiazepines as needed for agitation.[thepoisonreview.com]
    • If the patient has seizures or profound neuromuscular agitation, a serum CK and UA to look for rhabdomyolysis may be indicated. TREATMENT Treatment is primarily supportive.[uconnemig.wordpress.com]
    • Clinical findings Patient becomes drowsy 20 to 90 minutes after ingestion, then manic/agitated; in children, seizures may occur. Management Supportive, drugs for seizures.[medical-dictionary.thefreedictionary.com]
    • Origin: USA, NC Distribution: Throughout NC Poison Part: Mushroom Poison Delivery Mode: Ingestion Symptoms: Patient appears to be intoxicated, hallucinations, drowsiness, vomiting, nausea, stomach pains, diarrhea, muscle spasms, hypotension, agitation[plants.ces.ncsu.edu]
    • In cases of serious poisoning it causes a delirium , similar in effect to anticholinergic poisoning it is characterised by bouts of marked agitation with confusion, hallucinations, and irritability followed by periods of central nervous system depression[thepoisondiaries.tumblr.com]
    Ataxia
    • Psilocybin spp psilocybin-mediated onset in minutes: anxiety, mydriasis, ataxia, tacycardia, dyskinesia, hallucinations, delirium Disulfram-like; e.g. Coprinus spp coprine-mediated Glutaminergic, e.g.[lifeinthefastlane.com]
    • As might be expected, ibotenic acid has excitatory properties, causing agitation, confusion, visual changes (including illusions), myoclonus, and seizures, while muscimol has inhibitory properties, causing sedation and ataxia.[uconnemig.wordpress.com]
    • […] and the amount ingested per body weight, effects can range from nausea and twitching to drowsiness, cholinergic crisis -like effects (low blood pressure , sweating and salivation ), auditory and visual distortions, mood changes, euphoria , relaxation, ataxia[thepoisondiaries.tumblr.com]
    • In a review of 1 case of Amanita muscaria poisoning and 8 cases of Amanita pantherina poisoning, all in children from age 11 months up, symptoms began 30-180 minutes after ingestion. (106a) The dominant presenting features were ataxia, obtundation and[mykoweb.com]
    • Also in Poland, 2 women ate 5 fried caps of A pantherina (later confirmed) and developed nausea, stomachache, diarrhea, and vomiting within 2 hours. [18] They subsequently developed ataxia, waxing and waning obtundation, altered perceptions, hyperkinetic[emedicine.medscape.com]
    Excitement
    • Fly Agaric raises blood pressure and excites the central nervous system and is therefore dangerous.[thepoisondiaries.tumblr.com]
    • The combination of these opposing pathophysiologic effects results in an oscillation between lethargy and excited behavior, which may swing back and forth several times during the clinical course.[uconnemig.wordpress.com]
    • Muscarine binds with muscarinic acetylcholine receptors leading to the excitation of neurons bearing these receptors.[eol.org]
    Tremor
    • The fungus that causes grass staggers (tremors, stumbling and muscle spasms) in stock animals is an endophyte – it grows within the grass without harming it.[teara.govt.nz]
    • Poisoning is rare, but ingesting a larger amount can cause muscle tremors and other symptoms requiring hospital treatment.[helsenorge.no]
    • Gyromitra spp gyromitrin-mediated symptoms CNS symptoms: headache, ataxia, fatigue, nystagmus, tremor, bertigo, seizures (rare) 2-3 days: delayed hepatotoxicity (rare) 1-3 days after hepatotoxicity: hemolysis and methemoglobinaemia Immunohaemolytic, e.g[lifeinthefastlane.com]
    Hyperreflexia
    • Amanita muscaria and panterina 30min-2h: delirium, dysphoria, drowsiness, haullcinations, myoclonus, hyperreflexia, seizures Epileptogenic, e.g.[lifeinthefastlane.com]
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    • Entire body system
    Fever
    • In susceptible people, this irritating pollen causes hay fever. Many plants cause hay fever—grasses, alders, poplars, birches, elms, and maples, to name a few. Not everyone reacts to all allergenic plants.[novascotia.ca]
    • Fever, hematuria, tachycardia, hypotension, rapid volume depletion, and fluid and electrolyte imbalance also may be present. POISONOUS PRINCIPLES : A. muscaria. The toxins are choline, muscarine, and muscaridine. The LD 50 i.v. in mice is 0.23mg/kg.[research.vet.upenn.edu]
    • Initially, blood poisoning causes signs and symptoms such as chills, a spiking fever, a rapid heart rate, and a feeling of being extremely ill.[livingnaturally.com]
    • There is usually, also distinct fever and either hemoglobinuria or methemoglobinuria, and evidence of irritation of the kidney is shown by the presence of albumen, or partial suppression of the urine.[henriettes-herb.com]
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    • Jaw & Teeth
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    • Workup

    Treatment

    Prognosis

    Complications

    Fever
    • In susceptible people, this irritating pollen causes hay fever. Many plants cause hay fever—grasses, alders, poplars, birches, elms, and maples, to name a few. Not everyone reacts to all allergenic plants.[novascotia.ca]
    • Fever, hematuria, tachycardia, hypotension, rapid volume depletion, and fluid and electrolyte imbalance also may be present. POISONOUS PRINCIPLES : A. muscaria. The toxins are choline, muscarine, and muscaridine. The LD 50 i.v. in mice is 0.23mg/kg.[research.vet.upenn.edu]
    • Initially, blood poisoning causes signs and symptoms such as chills, a spiking fever, a rapid heart rate, and a feeling of being extremely ill.[livingnaturally.com]
    • There is usually, also distinct fever and either hemoglobinuria or methemoglobinuria, and evidence of irritation of the kidney is shown by the presence of albumen, or partial suppression of the urine.[henriettes-herb.com]
    Mushroom Poisoning
    • Synopsis Chapters: Amanita Muscaria, Amanita Phalloides, Mushroom Poisoning, Galerina Marginata, Amanita[amazon.in]
    • TITLE : Mushroom poisoning: Report of three cases with one death.[accessdata.fda.gov]
    • Fatalities from hallucinogenic mushroom poisoning are rare.[emedicine.medscape.com]
    • "All mushrooms are edible, but some only once." -- Croatian Proverb For references and more information about hallucinogenic mushrooms, see: Benjamin, D.R., Mushrooms: Poisons and Panaceas.[faculty.washington.edu]
    • Denis Benjamin describes a mass poisoning at a banquet occasioned by just such an error having been made in his book, Mushrooms Poisons and Panaceas .[williamrubel.com]
    Hallucinations
    • Dried fly agaric Amanita muscaria fruiting bodies were eaten by five young persons (18-21 years of age) at a party in order to evoke hallucinations.[ncbi.nlm.nih.gov]
    • Manifestations of A muscaria poisoning include: weakness, altered mental status, dizziness, somnolence, coma, hypersalivation, and hallucinations. Onset is within 30-120 min of ingestion with symptoms typically lasting for 8-12 hours.[thepoisonreview.com]
    • Twenty minutes post-ingestion, the participants began experiencing auditory hallucinations and illusions of enhanced color perception. One 18-year-old girl had particularly severe visual hallucinations, then lost consciousness.[uconnemig.wordpress.com]
    • Amanita muscaria Amanita muscaria contains muscimol that produces feelings of euphoria, hallucinations, muscle jerks, drowsiness, sweating, pupil dilation, and increased body temperature.[faculty.washington.edu]
    • Origin: USA, NC Distribution: Throughout NC Poison Part: Mushroom Poison Delivery Mode: Ingestion Symptoms: Patient appears to be intoxicated, hallucinations, drowsiness, vomiting, nausea, stomach pains, diarrhea, muscle spasms, hypotension, agitation[plants.ces.ncsu.edu]
    Anticholinergic Syndrome
    • Patients can develop symptoms similar to anticholinergic or cholinergic poisoning; however, the use of atropine or physostigmine as an antidote is not recommended as muscimol and ibotenic acid do not produce a true anticholinergic syndrome nor do they[eol.org]

    Etiology

    Causes

    Epidemiology

    Sex distribution
    Age distribution

    Pathophysiology

    Prevention

    Summary

    Patient Information

    Self-assessment

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    References

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    22. “Legal highs” on the net—Evaluation of UK-based Websites, products and product information - MM Schmidt, A Sharma, F Schifano - Forensic science , 2011 - Elsevier
    23. Caveat cenans!* - WA Valente, RJA Talbert, JP Hallett - American journal of , 2002 - ramsey1.chem.uic.edu
    24. Amanita muscaria: chemistry, biology, toxicology, and ethnomycology - D Michelot, LM Melendez-Howell - Mycological research, 2003 - Elsevier
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    29. A study of cultural bias in field guide determinations of mushroom edibility using the iconic mushroom, Amanita muscaria, as an example - W Rubel, D Arora - Economic Botany, 2008 - Springer

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