Volume 16, Number 2, Fall 2006

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Thirty-Plus Years of Mushroom Poisoning: Summary of the Approximately 2,000 Reports in the NAMA Case Registry
Michael W. Beug, Marilyn Shaw, and Kenneth W. Cochran
IN THE EARLY years of NAMA, toxicology was one of the concerns of the Mycophagy Committee. The existence of toxicology committees in the Puget Sound and Colorado clubs stimulated the NAMA ocers to separate the good and bad aspects of ingesting mushrooms. In 1973 they established a standing Toxicology Committee, initially chaired by Dr. Duane H. (Sam) Mitchel, a Denver M.D. who founded the Colorado Mycological Society. In the early 1970s Sam worked with Dr. Barry Rumack, then director of the Rocky Mountain Poison Center (RMPC), to establish a protocol for handling information on mushroom poisonings resulting in the center, becoming nationally recognized for handling mushroom poisonings. In 1982, encouraged by Dr. Orson Miller and acting on a motion by Kit Scates, the NAMA trustees then created the Mushroom Poisoning Case Registry. Dr. Kenneth Cochran laid the groundwork for maintaining the Registry at the University of Michigan. Dr. Cochran continues to maintain the gateway through which individuals can report mushroom poisonings using the NAMA Web site (www.namyco.org). The reporting is an entirely volunteer eort, and at the end of each year members of the NAMA toxicology committee assemble all of the reports for the previous year as well as any other earlier cases that can still be documented. In addition, members of the toxicology committee work with Poison Centers to directly gather mushroom poisoning reports. Marilyn Shaw (Colorado, Montana, Idaho, Hawaii and Las Vegas, Nevada)), Dr. Bill Freedman (California), Jan Lindgren (Washington and Oregon), Judy Roger (Washington and Oregon), Dr. Ken Cochran (Michigan and the upper Midwest), Hanna Tschekunow (Florida and Eastern U.S., now Washington), Dr. Denis Benjamin (WashingMcIlvainea 16 (2) Fall 2006 ton, now Texas) and many others have worked hard to track down and record details of mushroom poisoning cases. The rst annual NAMA report of mushroom poisoning cases was published by Dr. Cochran in Mushroom: The Journal in 1985 (Cochran, 1985). All subsequent reports are in McIlvainea (Beug 2006; Cochran, 1986, 1988, 1999, 2000; Lampe, 1989; and Trestrail 1991, 1992, 1994, 1995, 1996, 1997, 1998). In some of Dr. Trestrails reports (Trestrail 1992, 1994, 1995, 1996) he compares numbers of mushroom toxic exposures reported to NAMA to reports to the Poison Control Centers compiled through the Toxic Exposure Surveillance System of the American Association of Poison Control Centers. From this data we can infer that mushrooms account for about 0.4 to 0.5% of total toxic exposures. NAMA is receiving reports totaling about 1% of mushroom poisoning cases that are reported to Poison Control Centers each year. While about 90% of mushrooms in the Toxic Exposure Surveillance System are unidentied, NAMA involvement drops the percentage of unidentied mushrooms into the range of 1030%. Also, since approximately 80% of the reports to PCCs involve asymtomatic events, we conclude that NAMA reports get led for about 10% of the symptomatic poisoning cases (and probably well over 50% of the cases involving a fatality). The NAMA database that is maintained of all of the poisoning case reports that have been received by the toxicology committee is not readily accessible when questions arise. This paper summarizes all reports in the database where the mushroom could be reasonably well identied. We cover all material through December 2005. Unlike in the annual reports, we will not delve into treatments or why the person might 47

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that of a lumper. For example, Armillaria mellea and Laetiporus sulphureus; are now recognized as complexes of several species, but there has often been no way to gure out what the actual culprit was, though by looking at the location one can sometimes make a good guess. A confounding factor here is that mushrooms can be contaminated by bacteria and molds, and the symptoms from bacterial and mold contamination are extremely similar to most mushroom poisoning symptoms. Some of the cases certainly do appear to have resulted from consumption of spoiled mushrooms that were old before consumption or had been frozen raw (which allows the bacteria to keep growing). Also, for mushrooms growing in lawns, ower beds, along roads, and on golf courses there is the question of contamination by insecticides or heavy metals. In a few cases there was specic recollection of a recent Malathion or other insecticide spray. We have a Table of Poisonings where alcohol is implicated because there were individuals who said that they could eat the mushrooms if they did not drink alcohol. We are certain that several additional GI cases were also alcohol-related. We have tabulated all of the reported dermatitis cases because that information has remained scattered. Where the case involved both dermatitis and GI symptoms, the event was tabulated in both tables. We were surprised at some of the things that we found (or did not nd). In over 2,000 reports, there were only three cases total involving a Cortinarius species, even though that is a huge genus with many large, eshy fungi. We did not nd a single mention of a poisoning that matched the symptoms of orellanine poisonings. So far, orellanine has been found in only one small brown Cortinarius species in North America. A further check of other available sources also failed to come up with any orellanine cases anywhere in North America. While we have often seen 50% quoted as a death rate for consumption of mushrooms containing amatoxins, we calculated an 11% death rate for reported cases of people who became ill. The overall rate of death from amatoxins is well under 10% when you count the people who showed no symptoms. Furthermore, we only found record of ve liver transplants for a transplant rate of 3.5% in amatoxin cases. From other sources, we know that Galerina autumnalis can be fatal, but none of those reports has made

have consumed the mushroom (e.g. for food, for recreation, mistaken identication, etc.). The only age determination we make is for adults (and here we treat teenagers as adults) versus children. However, bear in mind that symptoms can be most severe in individuals whose health is previously compromised (due to age, alcohol or chronic disease) and in children whose digestive and immune systems are not yet fully developed. There are unusual cases where the death is not directly due to mushroom toxins. These include a previously severely ill elderly man who ate several successive huge meals of a Gyromitra species, but the symptoms related to his death did not match any known mushroom symptoms. A quadriplegic consumed purchased Psilocybe cubensis (of uncertain quality), went into anaphylactic shock, and died. One woman of a group of ve ate what was probably Laetiporus sulphureus, suered severe GI symptoms, dermatitis, and died in 19 hours while no one else in the group was even sick. After becoming unconscious from a large meal of Amanita muscaria, a man froze to death in his tent in Michigan. On the other side of the coin, we have not entered numerous cases where someone consumed an Amanita in the Destroying Angel group and had no ill eects or consumed a plateful of Chlorophyllum molybdites or some Amanita muscaria, etc., without getting sick. We have also not reported on the huge number of cases (roughly 33% of the total) where the cause of the poisoning is unclear due to the ingestion of several species at a time or due to the failure to preserve or produce any of the mushrooms for later identication. The reports that have been summarized here are voluntary reports. In some regions (the Rocky Mountain region and the Pacic Northwest) the reporting is quite extensive (though undoubtedly not complete). In other regions the reporting is very spotty because at times during the past 23 years there have been few active experts in the area. Sometimes one can be quite certain about what mushroom was consumed, but at other times it is just an educated guess based on mushrooms gathered near where the suspect mushrooms were picked or from pictures that the victim pointed out in a book. We have generally not attempted to use the most current name but have followed the names used in the reports. The approach has also been

Volume 16, Number 2, Fall 2006 its way into the database. Similarly, many cases of Galerina autumnalis ingestion that did not lead to death did not make this report. The one death reported from mushrooms causing GI symptoms with unknown toxins/irritants was from Boletus pulcherrimus. To our surprise, there were no reported deaths from the mushrooms noted for causing kidney failure, Amanita smithiana and Paxillus involutus. Though Amanita smithiana was at one time thought to contain orellanine, orellanine is not present. The toxin in Amanita smithiana is allenic norleucine that is probably bound to a sugar in the mushroom. A second compound, chlorocrotylglycine, may also be toxic. The toxins in Paxillus involutus are unknown. We found cases where mothers became ill from a mushroom ingestion, and nursing infants (and nursing puppies) became ill (the puppy died) from toxins in the milk. Though many people still eat Gyromitra esculenta, the large number of cases found where there was liver and/or kidney damage will, we hope, lead individuals to cease this practice.

49

In examining animal poisoning cases, we were struck by how frequently dogs (and even cats) consume either Amanita muscaria or Amanita pantherina. Neither of these species is deadly in humans, but both can be lethal to cats and dogs. Similarly there were deaths of dogs from both Inocybe species and Scleroderma species, though we have no record of human deaths from these same species. We looked for mushroom poisonings of horses or cows. There were no poisonings recorded for these animals, though there were two poisonings recorded for a pig, including one death. We tried to answer a question for a woman from Oregon whose prize horse was healthy one day and dead the next. Her pasture was full of mushrooms. Her vet said that similar deaths of horses are not all that unusual. We hope that someone who reads this will become curious and someday have an answer to whether or not mushrooms are involved in these mysterious horse deaths.

Table 1 Summary of Human Poisonings (excluding Dermatitis)

Classication Individuals Typical # Reported Reported Sick Cases/Year 1,641 147 68 52 + 77 (one big case) 218 108 959 176 98 58 70 6 3 3 10 5 40 8 4.5 3 8.9% 4.1% 3% 13% 6.6% 58% 10.7% 5.9% 3.5% % of total Number of Deaths (not counting shock) 17 16 0 0 0 0 1 0 0 0 % Deaths

Grand Total Amatoxins Gyromitra, Helvella, Verpa Morels Isoxazoles Psilocybin Total GI Chlorophyllum Omphalotus Leccinum

1% 11% 0 0 0 0 0.1% 0 0 0

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Table 2 Summary of Animal Poisonings
Animal Type of Mushroom Amatoxin Isoxazoles GI Irritants Amatoxin Isoxazoles GI Irritants GI Irritants Number Affected 12 10 3 11 61 47 2 Number Died 1 1 1 4 1 7 1 Number Euthanized 0 0 0 4 2 0 0 Total % Dead 50% 10% 33% 72% 5% 15% 50%

Cat Cat Cat Dog Dog Dog Pig

Table 3 Human Liver Damage and Kidney Failure Cases

Species Amanita bisporigera Amanita brunnescens Amanita smithiana Amanita ocreata Amanita phalloides Amanita verna Amanita virosa Amanita spp Galerina autumnalis & Galerina sp Lepiota josserandii Lepiota subincarnata Gyromitra esculenta Paxillus involutus Unknown species Number Poisoned 18 6 8 9 55 8 26 10 10 2 1 27 3 --Liver Damage Number Total 12 5 0 9 24 4 3 7 6 2 1 9 0 7 67% 83% 0% 100% 44% 50% 11% 70% 60% 100% 100% 33% 0% --Kidney Failure Number %Total 1 0 6 7 3 1 3 2 1 1 1 3 2 2 5.6% 0% 75% 78% 5.5% 12% 11% 20% 10% 50% 100% 11% 67% ---

Volume 16, Number 2, Fall 2006 Table 4 Amatoxin Syndrome: Poisoning by the Amanitins
Species & Location Number & Onset Symptoms

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Amanita bisporigera 16 adult+ AR, MI(2), MN, MO, 2 child NJ, OH, ON, QC, RI 715(24) hrs avg 10 hr Amanita brunnescens CA, ID Amanita magnivelaris RI Amanita ocreata CA(2), OR(2) 3 adult+ 3 child 618 hrs avg 16 hr 2 adults 24 hrs 9 adults 615 hrs avg 10 hr

Full gastrointestinal(18), cramps(5), kidney failure, liver damage(12), muscle spasms, salivation(2), drowsy, sweating(3), weakness(3), liver transplant(1), DEATH(2), elevated prothrombin time(2) Severe gastrointestinal distress(5), mild GI, chills, sweating, liver damage(5)

Severe gastrointestinal distress(2), DEATH(1) Gastrointestinal distress, cramps(2), disoriented(5), hypotension, kidney failure (7), liver damage(9), weak(2), DEATH(4) Gastrointestinal distress (49), bloody vomit, chills(2), cramps(17), Convulsions(3), disoriented(13), dyspnea(3), fever (8), severe headache, hypotension, salivation, drowsy, sweating(8), unconscious, weak(13), high prothrombin, coagulopathy, hyponatremia, respiratory failure(3), kidney failure(3), liver damage(24), liver transplant(3), DEATH(2) Gastrointestinal distress(6), chills, cramps(2), disoriented, kidney failure, liver damage(4), sweating, cerebral edema, DEATH(1) Gastrointestinal distress(23), severe GI, chills(2), cramps(4), convulsions, disoriented(5), fever, ushing, hypotension, kidney failure(3), liver damage(3), muscle spasms, nausea, drowsy(3), weak(5), edema, thick feeling in tongue, DEATH(1) Gastrointestinal distress (9), cramps(2), kidney failure(2), liver damage(7), mydriasis(2), drowsy, unconscious(2), weak, DEATH(3) Gastrointestinal distress(6), blood in vomit or diarrhea, cramps(6), dehydrated, disoriented(2), hematemesis, drowsy(2), weak(3), liver damage(5), unable to walk, dry heaves, infant poisoned from nursing Severe gastrointestinal distress, liver damage Gastrointestinal distress, confused, kidney failure, liver damage(2), respiratory distress, liver transplant(1), DEATH(1) GI, kidney failure, liver damage, drowsy, DEATH(1)

Amanita phalloides 52 adult+ BC CA(11), CT, NY, 3 child NJ, OR(2), PA, WA(2) (4) 612(30) hrs avg. 10 hrs

Amanita verna MI, MS, WA

6 adult+ 2 child (0.3)512 hrs avg 9 hr 23 adult+ 3 child (0.5)624 hrs avg 12 hr 9 adult+ 1 child 824 hrs avg 12 hr 8 adult+ 1 child 621 hrs avg 13 hr adult, 9 hrs 2 adults 915 hrs avg 12 hr

Amanita virosa CT, DC(3), CT, MI, MN, NJ, NY(5); QC, RI Amanita spp. FL, GA, KY, OR, NY, VA Galerina autumnalis/venenata AR, IL, KS, MI, OH, OR, WA Galerina sp OH Lepiota josserandii NY(2)

Lepiota subincarnata adult, 13 hrs BC

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

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Long Delayed-Onset Renal Failure: Orellanine or Cortinarin Poisoning in North America: NONE REPORTED

Table 5 Inebriation and Poisoning by Isoxazole Compounds (Muscimol, Ibotenic Acid, etc.)
Species & Location Number & Onset Symptoms

Amanita muscaria 107 adult+ AB(2), AK, CO(28), 2 child D(12), MA, MD, 0.53(12) hrs MT(6), NJ(9), NY, avg 1.5 hr OH(2), OR(8), PA(3), RI(3), SK, WV(2), VA(2), WA(7), WY(6)

Gastrointestinal distress (100), visual and/or time disturbances(39), atrial brillation(3), ataxic(3), chills(12), cramps(4), convulsions(3), disoriented(67), hematemesis, malaise, muscle spasm(47), nausea, salivation(3), drowsy(37), sweating(24), unconscious(11), deafness, out of body feeling, kidney polyuria, hypothermia. One death from freezing to death in a tent after consuming the mushrooms. Gastrointestinal distress(48), visual and/or time disturbances(72), anxiety(3), ataxic(9), cramps(9), disoriented(33), headache(6), fever(6), ushing, liver failure(1), muscle spasms 18, mydriasis, nausea(6), salivation(6), drowsy(12), sweating(6), unconscious(9), weakness(18), respiratory failure, kidney hematuria(2), dermatitis(2), violent(2)

Amanita pantherina BC(2), CA, CO(27), ID(11), MI, MT(7), NM, ON, OR(30), WA(14), WY

104 adult+ 5 child 0.36 hrs avg 2.4 hr

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Table 6 Mushrooms with Unique Toxins, Kidney Failure Common

Species & Location Amanita smithiana BC(2), OR(2), WA(3) Number & Onset 8 adult 611 hrs avg 8 hr 1 adult at 6 days 2 adults at 0.25 hr Symptoms Gastrointestinal distress(6), anxiety, chills, cramps(3), disorientation, kidney failure(6), malaise(2), sweating, weakness, warm feeling, oliguria, polyurea, thirst Kidney failure(2), incoherent, thirsty, hematemesis, muscle spasm, severe back pain, dry mouth, vomiting

Paxillus involutus OR, WA

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 7 Gyromitrin Poisoning Suspected due to Hydrazines and Morel Poisonings
Species & Location Gyromitra brunnea ID Gyromitra esculenta AK(2), IA, ID(2), MA, MI(17), QC, WA Number & Onset 24 adult+ 3 child 19(12) hrs avg 6 hr Symptoms

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adult, 23 hrs Gastrointestinal distress, sweating Gastrointestinal distress(27), anxiety, atrial brillation(3), chills(4), cramps, disoriented(6), dreams, fever, ushing(2), headache(2) jaundice, kidney failure(3), liver damage(9), muscle spasms, sweating(9), weak(5), methemoglobinemia, kidney hematurea, sensitive to sound Gastrointestinal distress(7), chills(2), cramps(3), jaundice, muscle spasm(3)

Gyromitra gigas/montana ID(9), MT(2), OR(3) Gyromitra spp ID(6), MI(3), MT(5), ) OR(3

8 adult+ 1 child 29 hrs avg 5 hr 22 adult+ 1 child 0.311 (24) hrs avg 3.5 hr

Gastrointestinal distress(18), ataxic, chills(4), convulsions, cramps(6) + severe cramps(4), isoriented(4), fever(2), headache(6), hematemesis, jaundice, liver damage, malaise, salivation, sweating(4), weakness(4), hot ashes(2), light sensitive, bilirubinemia, numb, neck pain Gastrointestinal upset, nausea burning throat Gastrointestinal distress Gastrointestinal distress(6) + 1 severe GI, cramps(2), disoriented(1), fever, nausea, sensitive to sound, unconscious, weakness(2), eaten raw = immediate numb mouth and throat Gastrointestinal distress(10) + severe GI(2,raw), chills(3), cramps(3), disoriented, nausea(2), sweating, weakness(3), atulence, numb hands, sneezing(24 hrs)

Helvella spp. CO Morchella angusticeps MI, MT Morchella deliciosa NC, CO Morchella elata BC, MT, OR(3), WA(4)

1 adult, 2 hrs Nausea, headache, hypotension, oating feeling 2 adults 0.5 hrs 2 adults 2.5 & 12 hrs 9 adults 0.13 hrs avg 1.5 hr 11 adult+ child 0.34.5 hrs avg 2.5 hr 25 adult+ 2 child 0.15.5 hrs avg 2.3 hr 77 adults (of 483) 0.3 hrs 8 adult+ 1 child 25 hrs avg 3.3 hr

Morchella esculenta ID, MD, MI(2), MO, NE, NJ, NY, WA(3)

Morchella spp CA, CO, ID(7), IL, MT(6), NM, OH(2), OR(3), WA

Gastrointestinal distress(26), chills(3) + severe chills, cramps(4), disoriented(5), fever, ushing(3), headache(7), hallucinations, muscle spasms(2), nausea, salivation, sweating(7), weakness(7), hot ashes, burning throat, bloated Gastrointestinal distress(77), bloating(4), cramps(7), ushing, sweating, and thirst (all at one banquet) Gastrointestinal distress(6), chills, cramps, disoriented(2), fever, ushing, headache, hypotension, malaise(3), nausea, salivation(2), sweating(2), vomiting, bloated, light-headed, hot ashes, dehydrated

Raw Morchella spp BC

Verpa bohemica CO(3), ID, MT(2), OR

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

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Table 8 Poisonings where Effects Appear to Be Associated with Alcohol Consumption

Species & Location Armillaria mellea OR Boletus barrowsii CO Boletus sp (red top) WY Clitocybe clavipes MI Coprinus atramentarius AK, ID(3), MI, MN, NY, WY(6) Coprinus comatus MI, NH

Number & Onset

Symptoms

4 adult, 5 hrs The four beer drinkers in the group were much sicker than others (all with gastrointestinal distress). adult 15 hrs adult, 5 hrs adult, 2 hrs adult 0.151.5 hrs 3 adults 0.52 hrs Person has 15-year history of adverse gastrointestinal reaction if alcohol is consumed with this species. Gastrointestinal distress, chills, fever, disoriented, salivation, dermatitis Tachycardia and palpitations, tingling arms and legs, ushing Tachycardia and palpitations(6), tingling arms and legs(6), ushing(6), headache, heavy limbs, salivation (time depending on when alcohol was taken). Gastrointestinal distress(2), cramps, chills, salivation, drowsy, sweating(2)

Coprinus quadridus KS adult, 27 hrs Tachycardia and palpitations, tingling arms and legs, ushing (time depending upon alcohol use). Coprinus sp OH Morchella angusticeps MI, CO Morchella elata+ M. semilibra OH Morchella spp MT, CO Pholiota squarrosa CO Pleurotus ostreatus MI, OR Pleurotus sp WI adult, 4 hrs 2 adult 3 & 4.5 hrs adult, 0.5 hr 0.5 hour 3 adult 10 hrs Gastrointestinal distress, chills, muscle spasms, sweating, weakness Gastrointestinal distress, disorientation, throat constricted Gastrointestinal distress, cramps, muscle spasm Severe cramps, disoriented, headache, muscle spasm, nausea(3)

adult, 4.5 hrs Gastrointestinal distress 2 adult Tachycardia and palpitations, tingling arms and legs, 0.3 &1.5 hour ushing, nausea, weakness, sweating, hallucinations Adult 5 hours Gastrointestinal distress, ushing, hypotension, muscle spasm, tachycardia

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006

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Table 9 Hallucinogenic Syndrome: Effects of Psilocybin and Psilocin and other Tryptamines
Species & Location Gymnopilus cf. luteofolius NY Gymnopilus spectabilis MA, MI, NJ(2), NY, OH, OR, RI, VA Panaeolus acuminatus BC Number & Onset adult, 1 hr 15 adult 0.32.5 hr avg 1.5 hr adult, 3 hrs Symptoms Gastrointestinal distress, hallucinations Gastrointestinal distress(2), anxiety(2), agitation, disoriented(7), ushing(2), nausea(2), hallucinations(10), drowsy, blurred vision, weakness, tingling limbs(3), numb(3), chest pain, paranoid(2) Cramps Nausea and sweating, an apparent panic reaction due to fear of having made an error. Gastrointestinal distress(9), disoriented(6), fever(3), ushing(2), nausea(6), hallucinations(7), salivation, drowsy(2), unconscious, angiodema, euphoric, insomnia, dermatitis(2), hives, screaming Flushing, gastrointestinal distress(4), weakness

Panaeolus campanulatus adult OH Panaeolus foenisecii CA(2), CO(3), ID, MA, MI(2), MT, OR(3), WA 8 adult+ 10 child 0.111(16) hrs avg 3 hrs

Panaeolus papilionaceus adult+ ME, ID 3 child 0.5 hr Panaeolus spp MT, HI 2 adult, 0.81 hr

Hallucinations(2), agitation, cramps, nausea Anonymous report that several times recreational use led to loss of muscular control & inability to walk for 610 hours. Anxiety, ushing, gastrointestinal distress, muscle spasms, tight chest Hallucinations(8), anxiety(2), ataxic(2), severe convulsions, disoriented(4), drunk feeling, hypotension(2), malaise, muscle spasms, mydriasis(3), nausea, salivation(3), sweating, tachycardia(2), unconscious(2), aggressive, detached, severe, rhabdomyolysis, respiratory arrest, violent. 1 DEATH from anaphylactic shock (allergic reaction) Hallucinations(6), agitated, chills, disoriented(3), fever, ushing(2), sweating(2), weak, coordination loss Hallucinations(15), anxiety(2), chills, cramps(3), disoriented(8), GI(10), mydriasis, drowsy(4), suicidal, unconscious, unable to walk, severe dermatitis Gastrointestinal distress, disoriented Hallucinations

Psilocybe azurescens OR adults ~1 hour Psilocybe baeocystis OR adult, 0.6 hr Psilocybe cubensis CA, CO(2), ID, MT, OH, OR(3) Note: Usually illicitly cultivated and often adulterated. Psilocybe cyanescens CA(2), CO, NC, OR(3) Psilocybe semilanceata CA, OR(6), WA(5) 14 adult 0.22.5 hrs avg 1 hr

8 adult 0.24.5 hr, avg 1 hr 15 adult+ 3 child 0.53(12) hr avg 2 hr 2 child 1.5 hour child

Psilocybe stuntzii OR(2) Psilocybe I subcaerulescens M

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

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Table 9, Hallucinogenic Syndrome: Effects of Psilocybin and Psilocin and Other Tryptamines, cont.
Species & Location Number & Onset Symptoms Hallucinations(15), gastrointestinal distress(5)+ severe GI(3), anxiety(5), atrial brillation, ataxic, chills(2), cramps(2), convulsions, kidney failure, liver damage, malaise, muscle spasms, mydriasis(2), salivation, drowsy(2), sweating, tachycardia(3), nausea, unconscious, suicidal, dry mouth(2), miosis, freaking out, seizure, cold extremities, kidney polyuria

Psilocybe spp 21 adult CA, CO(3), FL, HI, NY(3), avg 1.3 hr OR(6), WA 0.6-3.5 (36)hrs

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 10 Cases Involving Dermatitis or Spore Inhalation
Species & Location 35 species WA(2) Aman. pantherina WY Bol. pulcherrimus OR Boletus sp WY Calvatia gigantea NY Canth. cibarius OR C. molybditum TX C. nebularis WA C. semisanguineus QC Cort sp, C. vinicolor, O. olivascens CA Ingest no yes yes yes yes yes yes yes yes no Spore Onset 4.5 0.8 5 0.01 3 0.5 1 1 0.5 1418 9 48 0.1 0.2 12 0.1 Inhale Inhale 0.1 Inhale 1 1 24 24 18 18 24 12 Symptoms

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#1: joint stiffness, pain; #2: uid retention Gastrointestinal, etc, dermatitis Gastrointestinal, etc. dermatitis Gastrointestinal, etc. dermatitis Flushing, burning rash around mouth Edema, hives, numbness Dermatitis Hives Cramps, dermatitis Itchy rash eyelids and inner thighs #1: Tight chest, scratchy throat; #2 skin on re #1: GI, etc, dermatitis, DEATH (shock) #2: severe rash, whole body like P Ivy . GI, hives on scalp, neck & shoulder Long-lasting whole-body rash Contact with juice resulted in immediate burning sensation, like an acid burn (2) #1: Gastrointestinal, etc., dermatitis #2: Nausea etc., dermatitis, hives #3: Tingling & Itching hand & forearm #1: hives, erythema #2: rash & welts, nausea Tingling ngers, numb Diarrhea, runny nose and eyes hallucinations sv dermatitis GI, tachycardia, unconscious, sneezing Dyspnea, conjunct, rhinitis & rhinorrhea, lacrimation (both times) #1 & #2:dermatitis #3: eye irritation, tears, poison-ivy-like rash Dermatitis face & neck, swollen face & eyes both times Poison Ivy-like facial dermatitis both cases Edema, severe itching face & groin, puffy face Dermatitis, swollen face, etc.

Gyromitra prob. esculenta no ID(2) Laetiporus sulphureus OR, WI Lentinus edodes NY Leucoagar. naucina Omphalotus olearius GA(2) Panaeolus foenisecii CA, MI, OR Phallus impudicus CO(2) Phallus hadriani CO Pleurotus ostreatus P semilanceata WA . S. citrinum OR S. citrinum & S. macrorhizon MI(2) Suillus americanus MI(2), MA S. americanus & S. granulatus NH(2) S. granulatus MA(2) Suillus luteus? NY(2) Suillus pungens? CA yes yes yes yes no yes yes no no no no no yes no no no yes no no no no yes

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Table 11 Gastrointestinal Syndrome

Species & Location Agaricus arvensis PA Agaricus augustus WA(3) Agaricus californicus OR, CA Agaricus hondensis BC, CA, WA Agaricus placomyces & praeclaresquamosum ID, MI, OR(2),WI, WV

Number & Onset 2 adult, 2 hr 4 adult 2.56 hr, avg 4 hr 1 adult + 1 child 0.5 hr 3 adult 0.20.7 avg 0.4 hr 5 adult + 1 child 0.55 hrs avg 2 hr

Symptoms Both gastrointestinal distress, chills, drowsy, and weak Gastrointestinal distress, chills, cramps, dyspnea, nausea, sweating, rhinitis, sneezing, face numb Gastrointestinal distress, chills, nausea, weak (one event was suicide attempt, but the wrong mushroom to die from) Gastrointestinal distress(2), severe cramps

Gastrointestinal distress(4), cramps, headache, nausea, sweating, sneezing, rhinorrhea

Agaricus xanthodermus 11 adult complex, CA(2), CO(6), + 5 child ID(5), MT(2) 0.36 hrs avg 2 hr Agaricus (commercial) WA adult, 0.1 hr

Gastrointestinal distress(11) + severe GI(2), cramps (4), disoriented(2), fever, ushing(2), headache(2), nausea, hypotension, malaise, sweating(2), numb, warm feeling Gastrointestinal distress, severe disorientation, sweating, weak, difculty balancing Gastrointestinal distress (17), ushing(2), headache, sweating, tachycardia

Agaricus spp CA, CO(5), 16 adult + HI, ID, NM, NV, OK, 5 child OR, TX 0.35 hrs avg 1.7 hr Agrocybe dura NJ, OH A. pediades? OR A. praecox NM Agrocybe sp OK Amanita aviconia RI A. avorubescens NY Amanita frostiana AZ A. gemmata & A. crenulata NH(3), OR Amanita inaurata MT Amanita rhoadsii FL 2 child, 1&10 hr child, 14.5 hr child, 12 hr 2 adult, 4 hr child 5 adult 0.22(14) hr adult, 0.6 hr adult, 1.5 hr

Gastrointestinal distress Gastrointestinal distress, hallucinations Gastrointestinal distress, chills, drowsy

2 child, 0.6 hr Gastrointestinal distress Both with gastrointestinal distress, anxiety, bradycardia, ushing, headache, salivation, sweating Gastrointestinal distress Gastrointestinal distress(2), disoriented(2), ushing,weak(2), sweating, visual, drunk-feeling GI, sweating. nystagmus, blurred vision Gastrointestinal distress

adult, 0.3 hrs Nausea, chills

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 11, Gastrointestinal Syndrome, cont.
Species & Location Amanita rubescens CA(2), NJ A. russuloides NJ Amanita spreta ME A. triangulibulbosa CA Amanita vaginata ND, WA Amanita velatipes WV,QC Amanita velosa CA A. sec. Lepidella OR Amanita spp. OR, NJ(2) Number & Onset Symptoms

59

3 adult GI92) + severe GI, anxiety, chills, ushing, sweating, 1&5 hr, weak(2) avg 4 hr adult, 3.5 hrs Gastrointestinal distress, drowsy 2 adult, 3 hrs Atrial brillation, bradycardia, gastrointestinal distress adult, 2 hrs 2 adult 4 & 9 hrs 3 adult 6 hr child, 2 hr Gastrointestinal distress GI(2), chills, cramps, disoriented, hallucinations, drowsy, sweating Gastrointestinal distress(3), chills, hallucinations (1or2?), atrial brillation(1or2?) Gastrointestinal distress, disoriented, ushing, drowsy

adult, 45 hr Unconscious 3 adult + Gastrointestinal distress(4), chills, disoriented, muscle 1 child spasms, drowsy(2), weak 1.5, 3, 12 hrs

Armillaria albolanaripes 2 adult + Gastrointestinal distress(3) WA 1 child, 4 hrs Armillaria mellea group 38+ adult BC, ME, MI(2), NM, 0.211 hrs NY(2), OR(8), PA, WA(2), avg 4 hrs VT A. tabescens LA Boletus edulis & B. barrowsii CA, CO(5), CT, NH, WA Boletus pulcherrimus OR Boletus regius CA Boletus satanas CA(3), OR Boletus sensibilis NH B. subammeus MI B. subvelutipes NY Boletus spp. CA, NC, NH, OR 2 adult, 1 hr 13 adult 0.33(9) hrs avg 2 hrs 2 adult 0.8 hrs 4 adult 0.1-2.5 hr, avg 1.5 2 adult 2 hrs adult, 3 hrs adult, 2 hrs 4 adult + 2 child 0.5-4 hr, avg 1.7 Gastrointestinal distress(32+) + severe GI(3), chills(5), cramps(5), ushing(3), mydriasis, drowsy, sweating(7), weak(13), dehydrated, hypothermic(4) Gastrointestinal distress+ severe GI, salivation, sweating Gastrointestinal distress(11), atrial brillation, bradycardia, chills(2), severe cramps(2), disoriented, ushing(2), weak(2), itchy throat Gastrointestinal distress(2), fever, hypotension(2), dermatitis, Mallory-Weiss syndrome, DEATH(1) Gastrointestinal distress(4), hematemesis, salivation, sweating, weak, hypothermic, pallid Gastrointestinal distress(2), severe cramps(2), thirsty(2), leucocytosis, fever, numb Gastrointestinal distress Gastrointestinal distress Gastrointestinal distress(5), cramps, disoriented, headache(2), bloating, belching

adult, 1.5 hrs Nausea

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

60

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Table 11, Gastrointestinal Syndrome, cont.

Species & Location Caloscypha fulgens WA Calvatia fumosa CA Calvatia gigantea NY Cantharellus cibarius & formosus CA, CO(2), MI, OR(8), PA, WA(3) Number & Onset adult onset unkn Symptoms

Ataxic, muscle spasms, weak, shallow breathing

2 adult, 3 hrs Both disoriented, hypotension, nausea, unconscious, weak adult, 9 hrs Gastrointestinal distress, drowsy 17 adult Gastrointestinal distress(11) + severe GI, ataxic, 0.2-7(12) hrs chills(4), cramps(5) + severe cramps, disoriented(2), avg 1.8 hr hallucinations(2), malaise, sweating(2), sound sensitive, weak, swollen limbs, tight chest Gastrointestinal distress, fever Gastrointestinal distress, chills Gastrointestinal distress, sweating Gastrointestinal distress (52), anxiety(2), bradycardia(4), chills(4), convulsions(4), disoriented(2), dyspnea(2), fever(4), ushing, hypotension(6), muscle spasms (2), sweating(12), tachycardia, weak(4), tight chest Gastrointestinal distress(80) + severe GI(20), blood in vomit/diarrhea(7), hematemesis (15), hypotension(5), salivation(10), sweating(25), fever(10), ushing(5), chills(15), hallucinations(2), tachycardia, unconscious, weak(10), dermatitis(2), burning mouth and throat, shock, kidney hematuria(2) GI, disoriented, ushing, sweating, salivation, weak Gastrointestinal distress, hives Gastrointestinal distress(5) + severe GI, cramps, disoriented, headache, malaise, salivation, weak(2) Gastrointestinal distress(7), bradycardia, chills, cramps(3), disoriented, malaise, sweating, severe atulence(2) Gastrointestinal distress, chills, headache, sweating Severe gastrointestinal distress(4) Cramps, light sensitive, pallid, parethesia, tears

C. infundibuliformis WA adult onset unkn C. subalbidus OR Catathelasma ventricosa NM adult, 2 hrs 2 adults 23 hrs

Cooked Chlorophyllum 60 adult molybdites AL, CA, 0.56 hrs CO(19), CT, DC, FL, HI(3), avg 3.5 hr IA(2), MD, VA MI(2), MX, NH, NJ(6), NM, OH(5), SC, TX Raw C. molybdites AR(2), AZ(2), CO(53), DC, FL(2), HI(9), IA(9), IL(3), LA, MI, MO, MX(2), NC(3), NJ(9), NM(2), NV(3), OH(2), OK, PA, SC, TN(2), TX(3) Clitocybe inversa OR C. nebularis WA Clitocybe nuda MA, NY(2), OR, WA Clitocybe spp. CA(2), CO, ID, MT Clitopilus prunulus CA Collybia acervata OR Collybia sp. OR Conocybe lactea NJ 106 adult + 10 child 0.58(12) hrs avg 2.7 hrs

adult, 1.52 hrs adult, 1 hr 6 adult 218 hr, avg 11 8 adult 0.53(12) hr adult, 1 hr 4 adult, 1 hr

Adult, 0.1 hour

Child, onset? Gastrointestinal distress

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 11, Gastrointestinal Syndrome, cont.
Species & Location Conocybe sp. NM Coprinus comatus ID, MA(2), MD, ME, MI, NH, ON, OR Coprinus sp CA, WY Number & Onset Symptoms

61

child, 1.5 hrs Gastrointestinal distress, irritable 8 adult + 1 child 18 hrs avg 4.5 hr 4 Adult + 1 child 2.5 hrs Gastrointestinal distress(7), bloody GI, atrial brillation, chills, disoriented, salivation, drowsy(2), sweating(2) Gastrointestinal distress, tachycardia

Cortinarius semisanguineus QC C. violaceous WA Craterellus cornucopioides NC Crepidotus sp WA

adult, 24 hrs Cramps and dermatitis from consuming 37 cooked caps adult, 0.75 hr Drowsy, sneezing adult, 1.5 hr adult, unkn Gastrointestinal distress, chills, sweating Gastrointestinal distress, disorientation, sweating

Entoloma abortivum NH adult, 12 hrs Gastrointestinal distress, chills, muscle spasms, sweating Entoloma aprile OH E. bahusiense CA Entoloma grande AB Entoloma luridum QC E. rhodopolium CA Entoloma sinuatum CA Entoloma spp. CO, OH, OR 4 adult, 12 hrs Gastrointestinal distress, cramps, sweating, dehydrated

adult, 1.1 hrs Gastrointestinal distress adult, 0.3 hrs Gastrointestinal distress, cramps 4 adult, 23 hrs adult, 1 hr adult, 0.5 hr 4 adult + 1 child 0.62.5 hr avg 1.9 adult, 2 hrs Gastrointestinal distress, cramps Gastrointestinal distress, sweating Gastrointestinal distress then unconscious Gastrointestinal distress(2) + severe GI(2), chills(2), cramps, malaise, nausea, weak(2), miosis

Flammulina velutipes CO

Gastrointestinal distress, sweating, weak, may be associated with alcohol consumption Dyspnea, ushing, headache, burning throat and tongue Gastrointestinal distress(3), severe cramps(2)

Fuscoboletinus paluster adult, 0.1 hr QC Gomphus occosus CO, ME, WV Grifola frondosa IN, MA(3), MI(2), NY(2), PA, WI 3 adults 3.59 hrs, avg 5.5

10 adult + Gastrointestinal distress(8) + severe GI, chills, 2 child convulsions, cramps, disoriented, tinnitis(3), weak(4), 26(13.6) hrs drowsy and very drowsy, drunk-feeling avg 3 hr

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

62

McIlvainea

Table 11, Gastrointestinal Syndrome, cont.

Species & Location Hygrophorus puniceus CA Hygrophorus speciosus CO Number & Onset 2 adult, 1.5 hr child, 1 hr Symptoms

Both with gastrointestinal distress, disoriented, hallucinations Gastrointestinal distress, chills, headache, sweating, miosis, glassy-eyed Cramps Severe gastrointestinal distress, disoriented, sweating, weak, burning throat, swelling sensation Typical muscarinic symptoms Gastrointestinal distress, cramps, disoriented, hallucinations, salivation

Hypholoma sublateritium child DC onset unkn Hypomyces lactiorum OR, CA Inocybe geophylla QC Inocybe spp. FL, OH, WA 2 adult 0.1 & 4 hrs child, adult+ 2 child 0.51 hr, avg <1 hr

Laccaria ochropurpurea MA Lactarius aquiuus MI L. chelidonius CO Lactarius s sp. NY Laetiporus sulphureus group, CA(10), CO, MI, NC, OR(6) Leccinum atrostipitatum AK Leccinum aurantiacum group, CO(6), OR(2), WA L. brillosum CO Leccinum insigne UT L. manzanitae CA L. testaceoscabrum AK Leccinum spp. CA, CO(20), MX(5), WY

adult, 0.5 hr Gastrointestinal distress 2 adult, 0.5 hr 2 adult, 1.5 hr 36 adult + 1 child 0.54 hrs adult, 2 hrs 18 adult 0.59 hrs avg 4 hr child, adult, 1 hr adult, adult, 48 hr 31 adult+ 4 child 1.512 hr avg 2.6 hr 5 adult 0.39 hr avg 5 hr Both with gastrointestinal distress Gastrointestinal distress, atulence

10 adult, 1 hr All with gastrointestinal distress, cramps Gastrointestinal distress(26) + bloody GI, cramps(2), disoriented(4), fever, ushing, headache(3), nausea(2), salivation, sweating(3), chest pain, dermatitis, nursing baby=vomiting, Death(1) in 19 hrs from 3 bites Gastrointestinal distress Gastrointestinal distress(12) + severe GI(2), ataxic, chills(2), disoriented, malaise, sweating, weak Gastrointestinal distress Headache Gastrointestinal distress GI, lingual lesions (other causes suspected) Gastrointestinal distress(17) + severe GI(3), cramps, disoriented, headache(2), hematemesis(2), malaise(4), nausea(2), blurred vision, weak, dry throat, atulence(3) Gastrointestinal distress(4), chills(2), disoriented, headache, muscle spasms(2), unconscious, weak(2), hives, difculty breathing

Lentinula edodes CA, CO, NY(2), unkn

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 11, Gastrointestinal Syndrome, cont.
Species & Location Lepiota cepaestipes OR Lepiota procera MI Lepiota rachodes CA(7), CO(4), ID(2), OR, WA L. rubrotincta CA(2) Lepiota spp. NE, NM, TX Number & Onset adult, adult, 1 hr Symptoms

63

Gastrointestinal distress, cramps, disoriented Gastrointestinal distress

15 adult Gastrointestinal distress(10) + severe GI(2), chills(2), 0.110(22) hrs cramps, convulsions, disorientation, malaise(2), avg 4 hr nausea(2), salivation, drowsy, sweating, weak(3), chest pain, rhinitis 2 adult, .8 & 1.4 hr 3 adult+ 2 child 2.57 hr avg 4.5 3 adult+ 5 child 0.210 hr avg 4 hr adult, 8 hrs 4 adult 0.3-2 hr avg 1hr adult, 6 hrs Gastrointestinal distress, nausea Gastrointestinal (3) + bloody GI, bradycardia, headache, hypotension, salivation, sweating, weak, kidney hematuria Gastrointestinal distress(7), cramps, nausea, salivation, irritable, acid reux

Leucoagaricus naucinus/leucothites CA(2), FL, ID, NC, OR, QC, WA Leucopaxillus sp. OH Lyophyllum decastes AK, MI, WA Macrolepiota venenata NY Marasmius oreades CO, MT(2), OR Melanoleuca sp CO Mycena sp OR(2)

Gastrointestinal distress Gastrointestinal distress Gastrointestinal distress, hallucinations(2), euphoric(3), tachycardia Gastrointestinal distress, chills, disoriented, hypothermic

Lycoperdon perlatum OR adult, 1 hr

2 adult+ Gastrointestinal distress(5), hallucinations, sweating(2) 3 child Possibly 2 victims result of nearby Malthion application 0.31(24) hrs child, 1.5 hrs Gastrointestinal distress 3 child, 5 & 8 hr Gastrointestinal distress(2), cramps Gastrointestinal distress Gastrointestinal distress (80) + severe GI(9), disoriented(3), headache(11), hallucinations, salivation(5), drowsy(6), sweating(8) + severe sweating(5), weak(14), drunk-feeling(2), light-headed(5)

Nevatogastrium wrightii adult, 1 hr CA Omphalotus olearius & olivascens CA, CT, FL(2), GA, IA, IN(3), MA(2), MD, ME, MI(2) , NC(2), NJ(7), NY(8), OH(5),ON(15), PA, QC(6), VA, WA(3), WV(3) Phaeolepiota aurea AK(2), WA(2) 96 adult+ 2 child 0.16 hrs avg 2 hr

4 adult Gastrointestinal distress(3), severe nausea 0.52(17) hr

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

64

McIlvainea

Table 11, Gastrointestinal Syndrome, cont.

Species & Location Phallus impudicus CO, OK Phallus ravenelii WI Pholiota aurivella OR P kodiakensis (AK) . Pholiota squarrosa AB, CO(2), MN, MT, WY Pleurotus ostreatus CA, MI, OR(4), VT, WA Number & Onset 2 adult, 1 hr adult, 4 hrs adult, 3 hrs 2 adult, 23 hrs 12 adult 0.1-7.5 hr avg 4 hr 8 adult+ 1 child 0.55 hr avg 2 hr 2 adult, 2 adult, 1.5 hr 2 adult, 8 hr adult 4.5 hr adult, 9.5 hr adult, 2 hr Symptoms

Gastrointestinal distress, cramps, tachycardia Gastrointestinal distress, severe headache GI, chills, cramps, disorientation, muscle spasm GI(2), cramps(2), disoriented(2), salivation, drowsy, sweat Gastrointestinal distress(7) + severe GI(2), fever(3), weak, atulence Gastrointestinal distress(7), disorientation, fever, nausea(2), salivation, drowsy(2), weak(2), dry mouth. One was a suicide attempt but wrong mushroom. Both with gastrointestinal distress and cramps Gastrointestinal distress(2), severe cramps(2), fever Gastrointestinal distress(2), cramps Gastrointestinal distress Muscle spasms, nausea, weak, sharp substernal pain Gastrointestinal distress Gastrointestinal distress Gastrointestinal distress, nausea after smoking it in attempt to get high Gastrointestinal distress, disoriented, convulsions Both with gastrointestinal distress Gastrointestinal distress, chills, fever Gastrointestinal distress(2), severe chills(2), cramps, fever, hematemesis(2), leucocytosis, anuria Gastrointestinal distress(7) + bloody GI, chills(4), cramps(3), disoriented, nausea(2), mydriasis, salivation, sweating(2), tachycardia, weak(2), agitated, breathing dif. Gastrointestinal distress, sweating(2), disoriented(3), hypotension(2), malaise, drowsy, blurred vision

Pleurotus sp. MT Pluteus cf. atromarginatus MT Ramaria cf. aurea CO Ramaria sp. WA Ramariopsis lentofragilis ME Rhodocybe nitellina CA

Russula cf. claroava VA adult+child 4 hr Russula cf. emetica CO, MT Russula nigricans OR R. occidentalis WA Russula paludosa + R. lutea AB Russula virescens VA 2 adult 6 & 18 hr child, 0.5 hr 2 adult, 4 hr adult, 8 hr

2 adult, 4.5 hr Gastrointestinal distress

Russula xerampelina CO 2 adult, 3 hr Russula spp CO(5), NC, NM 12 adult+ child 0.3-6 hr avg 4 hr 5 adult+ child 0.32 hr avg 1 hr

Scleroderma cf. cepa CA(2), CO, OR(2), WA2

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 11, Gastrointestinal Syndrome, cont.
Species & Location Scleroderma citrinum OR, PA S. geaster DC Scleroderma lycoperdoides QC Number & Onset 5 Adult 0.84 hr avg 2 hr Child, 9 hr 2 adult+ child 0.52 hr, avg 1 hr 4 adult+ child 0.14.5 hr avg 1.7 child, 9 hrs Symptoms

65

Gastrointestinal distress(5)

Gastrointestinal distress Gastrointestinal distress, malaise, nausea, visual disturbance, fever, dry mouth, throat constricted

Scleroderma spp GA, OR(3)

Gastrointestinal distress(5), chills(3), cramps(2), disoriented(3), mydriasis, drowsy(2), sweat(2), weak(2)

Stropharia rugosoannulata NJ Suillus albidus CA Suillus brevipes CO S. brunnescens CA Suillus granulatus CO Suillus luteus MT, NJ, NY(2)

Gastrointestinal distress

adult, 0.75 hr Gastrointestinal distress 2 adult, 1.5 hrs adult, 1.1 hr adult, 1.5 hr 6 adult+ 2 child 0.5, 0.8 & 12 hr adult, 1.5 hr adult, 12 hr 2 adult, 4 & 6 hr 3 adult 0.5-2.5 hr avg 2 hr 2 adult, 1 & 8 hr 7 adult 2 & 3.5 hr 8 adult, 1 hr 2 adult 0.5 hr GI(2), chills, cramps, disoriented, weak, diplopia Nausea Gastrointestinal distress, malaise, head felt heavy Gastrointestinal distress(7), disoriented(3), malaise(3), weak(3)

Suillus pictus NC Suillus pungens CA S. tomentosus CO(2) Tricholoma focale OR, CA T. magnivelare WA(2) T. pardinum ON, OR T. pessundatum CA T. saponaceum ID Tricholomopsis decora ID

Gastrointestinal distress Anxiety, disoriented, dermatitis, hyperpnea, swollen face Gastrointestinal distress, chills, disoriented Gastrointestinal distress(3), headache(2), malaise, weak

Gastrointestinal distress, headache, dry mouth Gastrointestinal distress(7), chills

adult, 5.7 hrs Gastrointestinal distress Severe gastrointestinal distress(8) Gastrointestinal distress, chills, ushing, hypotension, severe salivation, severe sweating, blurred vision

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

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McIlvainea

Table 11, Gastrointestinal Syndrome, cont.

Species & Location T. platyphyla ME Truncocolumella citrina MI Tylopilus arborate NJ Tylopilus eximius ME, NY, QC Number & Onset Symptoms

2 child, 2 hrs Gastrointestinal distress adult, 0.5 hr adult, 1 hr 12 adult+ child 23(12) hr avg 3 hr 2 adult, 1.5 & 3 hr child, 0.3 hr Gastrointestinal distress, chills, sweating, weak Gastrointestinal distress Gastrointestinal distress(13), chills, cramps, sweating, weak

Volvariella spp NV, CO Xerula megalospora NY

Severe gastrointestinal distress, disoriented, sweating Gastrointestinal distress, pallid

Table 12 Poisonings of Animals

Species & Location Agaricus sp CO Amanita bisporigera NC Amanita muscaria CO(3), OR Amanita muscaria AK, CO(9), MI, MN, NY Animal & Onset Cat, Dog, 6 Cats 0.32 hr avg 1 hr 15 Dogs 0.86 hrs avg 2 hr Symptoms Gastrointestinal distress, disoriented, foaming at mouth Gastrointestinal distress, disoriented, anemic, hypoglycemic, EUTHANIZED Gastrointestinal distress(5), apparent hallucinations(2), agitated, muscle spasms, mydriasis, nausea, salivation, drowsy(2), weak, DEATH(1) in 1 hour Gastrointestinal distress(6), apparent hallucinations(3), agitated, ataxic(6), chills, cramps, disoriented(6), ushing, malaise(3), muscle spasms(10), mydriasis(4), salivation(6), sweating, tachycardia, unconscious(3), weak(2), red staring eyes(2), panting, could not stand(2), (1) Apparent hallucinations, agitated, convulsions, disoriented(3), muscle spasms(2), mydriasis, salivation, sweating, drowsy, unconscious and nearly unconscious, could not stand(2), fear, slow respiration Gastrointestinal distress (8), apparent hallucinations (15), agitated(13), ataxic(20), confused(2), convulsions(9), cramps, disoriented(13), dyspnea(3), fever, malaise(4), muscle spasms(21), mydriasis(8), salivation(3), sleepy(7), biting(5), fearful(9), atulence, panting(5), hypercalcemia, sound sensitive(3), DEATH(1), EUTHANIZED(2)

Amanita pantherina CO(2), OR(2)

4 Cats 4 hr (1 report) 44 Dogs 0.83 hrs avg 2 hrs

Amanita pantherina AR, BC(2), CO(38), MI, OR, WA

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

Volume 16, Number 2, Fall 2006 Table 12, Poisonings of Animals, cont.
Species & Location Amanita ocreata CA Amanita phalloides CA(2) Amanita thiersii CA(2) Amanita sp CO Amanita sp OH Chlorophyllum molybdites TN, FL Clitocybe dealbata WA Conocybe sp CO Galerina sp AB Gymnopilus purpuratus CO Gymnopilus sp CO Gyromitra sp ID Hebeloma cf. Crustuliniforme WA(2) Hypholoma fasciculare CO Inocybe fastigiata OR Inocybe geophylla & I. lilacina OR(3) Inocybe spp CO, OR, VA Lepiota josserandii UT Lepiota sp WA Marasmius oreades CO, NV Melanoleuca melaleuca OR Panaeolus foenisecii CO(4), MI, WA Paxillus involutus OK Pisolithus tinctorus CA Pleurotus sp CO Psathyrella velutina NY Psilocybe pelliculosa OR Dog, Cat, Dog, Dog, Dog, 2 Dogs, Dog, Dog, 0.5 6 Dogs, 3 Dogs 0.5 hr (1 report) 2 Dog, Dog, 2 Dogs, Dog, 6 Dogs 0.1-4 hr, avg 2.5 hr New Zealand Pig Number & Onset Dog, 8.5 3 Dogs 2 Dogs, Cat, Dog, Symptoms

67

Gastrointestinal distress, jaundice, unconscious Gastrointestinal distress, disoriented, muscle spasms, weak(3), nursing puppy and its mother DIED GI(2), disoriented, liver damage, DEATH(1) GI, anxiety, agitated, bradycardia, hypothermia, DEATH Severe GI, liver damage, EUTHANIZED 2 Dogs, DEATH(1) Gastrointestinal distress + bloody GI,

GI, bradycardia, hypotension, salivation, miosis GI, agitated, dyspnea, salivation, miosis Gastrointestinal distress, wobbly, staring Disoriented, staggering Gastrointestinal distress Both with gastrointestinal distress and malaise GI, bradycardia, malaise, staggering Gastrointestinal distress, salivation Gastrointestinal distress(6), DEATH(3) Gastrointestinal distress(2) + severe GI, cramps, salivation + severe salivation, hallucinations, gas, pin-point pupils GI, liver damage(2), malaise(2), nausea, salivation, weak(2), DEATH(1) GI, salivation, sleepy, near death, 2 week recovery Gastrointestinal distress, salivation, frothy, unsteady Gastrointestinal distress, salivation, convulsions GI(4), anxiety, ataxic, agitated(2), malaise, muscle spasms, hallucinations, salivation, sleepy, weak, foaming at mouth GI, salivation, weak from 1 bite

Cat, 0.7 hr GI, drowsy, anorexia

Dog, 0.5 hr GI, salivation, weak, respiration depression

2 Dogs, 2 hr GI(2) from very old decaying mushrooms Dog, 0.1 hr Gastrointestinal distress, weak Dog, 0.5 hr Hallucinations, disoriented

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

68 Table 12, Poisonings of Animals, cont.

Species & Location Ramaria pallida CO Russula rosacea NC Russula spp.CO(2), MT Scleroderma cf. Cepa CO, NJ Scleroderma citrinum CA Scleroderma spp. CA(2), OR Suillus cf. Luteus WA Tricholoma pardinum+ Paxillus atrotomentosus OR Puffball MT Number & Onset Dog, 2 Dogs, 3 Dogs, 3 Dogs 0.2-6 hr avg 3 hr

McIlvainea

Symptoms

GI, salivation, dry heaves Both with bloody GI GI(3), malaise, increased phosphate levels Gastrointestinal distress (2), weak

Pot-bellied Consumed one specimen and DIED several hours later Pig 3 Dogs 0.1 hr) (1 report) Dog, GI, liver damage(2), DEATH(2)

Gastrointestinal distress

Cat, 0.5 hr Convulsions and DEATH

Dog, 0.5 hr Gastrointestinal distress

1 Number in parentheses is number of times observed. 2 Number in parentheses is one report of unusually long or short onset not included in average.

References
Beug, Michael W. 2006. Mushroom poisonings reported in 2001, 2002, 2003 and 2004. McIlvainea 16(1): 5669. Cochran, Kenneth W. 1985. Mushroom Poisoning in 1984. Mushroom 3(2): 3033. Cochran, Kenneth W. 1986. NAMA Mushroom Poisoning Case Registry. McIlvainea 7(2): 3538. Cochran, Kenneth W. 1988. NAMA Mushroom Poisoning Case Registry: Cases Reported in 1987. McIlvainea 8(2): 3032. Cochran, Kenneth W. 1999. 1998 Annual report of the North American Mycological Associations mushroom poisoning case registry. McIlvainea 14(1): 9398. Cochran, Kenneth W. 2000. 1999 Annual report of the North American Mycological Associations mushroom poisoning case registry. McIlvainea 14(2): 3440. Lampe, Kenneth F. 1989. NAMA Poisoning Registry 1988. McIlvainea 9(1): 2830.

Trestrail, John. H. III. 1991. Mushroom poisoning case registry: NAMA report 198990 McIlvainea 10(1): 3639. Trestrail, John. H. III. 1992. Mushroom poisoning case registry: NAMA report 1991. McIlvainea 10(2): 5155. Trestrail, John. H. III. 1994. Mushroom poisoning case registry: NAMA report 1993. McIlvainea 11(2): 8791. Trestrail, John. H. III. 1995. Mushroom poisoning case registry: NAMA report 1994. McIlvainea 12(1): 6873. Trestrail, John. H. III. 1996. Mushroom poisoning case registry: NAMA report 1995. McIlvainea 12(2): 98104. Trestrail, John. H. III. 1997. Mushroom poisoning case registry: NAMA report 1996. McIlvainea 13(1): 6367. Trestrail, John. H. III. 1998. 1997 Annual report of NAMAs mushroom poisoning case registry. McIlvainea 13(2): 8691.