FUNGAL TOXINS AND THEIR PHYSIOLOGICAL EFFECTS

D.W.Gover

Diagnosis of Syndrome from Observed Symptoms

It is very difficult to assign a case of fungal poisoning on the basis of symptoms alone. The symptoms are often non-specific or too variable and where dishes contain a mixture of fungi several symptoms may overlie each other. Further, the amount of toxin contained in the fungi may vary in relation to the age and condition of the fungi. Nevertheless, symptomatology based diagnosis of poisoning by fungi is useful particularly if no material of the toxic fungi is available.

When available, an examination of any fungal remains, by a competent authority, is doubtless the best way to make clear the poisoning syndrome.

TOXIN	EXAMPLES OF FUNGI INVOLVED	SYNDROME, LATENT PERIOD AND SYMPTOMS	DURATION OF ILLNESS
Amatins (Amatin, Phalloidin)	Amanita phalloides Galerina spp. (Amanita virosa contains amanitins and virosine a virotoxin.)	Phalloides syndrome. Latent period.6 to 24h. Vomiting, diarrhoea, abdominal pain, liver and kidney collapse, followed by coma and death.	10 to 20 days. If lethal, death usually 4 to 7 days after first symptoms.
Ibotenic acid - muscimol	Amanita muscaria Amanita pantherina	Pantherina syndrome. Latent period. 0 5 to 3h after ingestion. Muscle spasm, dizziness and deep sleep (hallucino-genic dreams).	10 to 15h deep sleep, loss of memory of intoxication. Occasionally, initially weak symptoms of muscarine poisoning.
Orellanine	Cortinarius orellanus C. gentiles C. speciosissimus C. orellanoides Cortinarius spp. should be avoided.	Orellanus Syndrome. Latent period. Delayed, may be 2 to 17 days after ingestion. Abdominal pain, nausea, vomiting, chronic kidney damage, may be fatal.	Symptom development may be delayed for some weeks after ingestion.
Gyromitrin	Gyromitra esculenta Gyromitra all species are poisonous.	Gyromitra syndrome. Latent period. 2 to 12h after ingestion. Nausea, vomiting, diarrhoea, stomach cramps, faintness, loss of muscular control, coma and death.	Recovery may begin after 2 to 6 days. In worst cases death while in coma after 2 to 3 days.
Coprine	Coprinus atramentarius Clitocybe clavipes	Coprinus syndrome. Latent period. 0.5 to 1h after ingestion of fungus and alcohol or use of alcohol up to 3 days after eating fungus. Hot flushes, headache, nausea and vomiting.	2 to 4h. Recovery occurs after alcohol leaves the system. Rarely serious. Symptoms parallel those of Disulfiram (Antabuse), used for treatment of alcoholics.
Gastro-irritants	Agaricus xanthodermus Boletus satanus Chlorophyllum molybdites Entoloma sinuatum Hebeloma crustuliniforme Lactarius torminosus Naematoloma fasciculare Omphalotus olearius Pholiota squarrosa Ramaria formosa Russula emetica Scleroderma citrinum Tricholoma pardinum	Gastro-intestinal syndrome. Latent period.0.5 to 4h. Vomiting, diarrhoea, and stomach cramps.	Recovery usually occurs within 3 to 4h, may last up to 2 days. Some cases may require hospitalisation.
Psilocybin Psilocin	Psilocybe cubensis Psilocybe semilanceata and related species. Gymnopilus spectabilis. Copelandia cyanescens. Some species of Panaeolus.	Psilocybin syndrome. Latent period. 0.5 to 2h after ingestion. Mood change; pleasant or apprehensive unmotivated laughter, visions, hallucinations, delirium ending in complete unconsciousness.	4 to 10h, sometimes longer.
Muscarine	Clitocybe dealbata Clitocybe phyllophila And most species of Inocybe. (Note: Amanita muscaria has a very low muscarine content).	Muscarine syndrome. Latent period. 0.5 to 2h, mostly 15 to 30 minutes, after ingestion. Perspiration salivation, blurred vision, decreased blood pressure, diarrhoea, slowed pulse.	12 to 24h, sometimes 2 to 4 days, may require hospitalisation, rarely causes death.
Unknown (Immune injury, immuno- haemolytic aneamia, (caused by destruction of red blood cells))	Paxillus involutus	Paxillus syndrome. Latent period. Continued ingestion results in an acquired hypersensitivity. Diarrhoea, vomiting, gastro-intestinal upsets, allergic reactions (anaphylactic shock), chronic kidney damage, and massive haemolysis.	2 to 4 days, may be serious, may cause death from a breakdown of the circulatory system.
Unknown (Fungus reportedly contains the toxin illuden S)	Omphalotus nidiformis	Syndrome not defined. Latent period. 0.5 to 2h after ingestion. Acute vomiting.	1 to 2 days, alarming but not lethal.
Ergotamine, Ergometrin, Ergonovin, Lysergic acid	Claviceps purpurea	Syndrome-Ergotism (St. Anthony’s Fire) Latent period. 2 to 12h. Two forms; Gangrenous, - one or more limbs lost, then death. Convulsive, -repeated convulsions and intense pain ending in death.	If fatal dose ingested, death in 3 to 4 days. Used medicinally to induce labour and prevent post partum haemorrhage during childbirth.