Overview of Fungal Intoxication

According to the mechanism of mycotoxins, several syndromes are ddescribed. Differentiation of fungi is possible only be microscopic mycological examination from food residues or from the contents of the stomach or stool,

Gastroenterodyspatic Syndrome

 * Latency: < 2 hours
 * Symptoms: gastrointestinal symptoms
 * Toxins: unknown
 * Treatment: symptomatic care
 * Prognosis: good
 * Note: -
 * Examples of fungi: Satan's bolete (Rubroboletus satanas), some of the Agaricus genus and the Russula genus.

Muscarinic Syndrome

 * Latency: < 2 hoours
 * Symptoms: sweating, salivation, lacrimation, miosis
 * Toxins: muscarin
 * Treatment: gastric irrigation, administration of atropine
 * Prognosis: depends on the amount ingested
 * Notes: -
 * Examples of fungi: some of the Inocybe genus and the Clitocybe genus.

Psylocibin Syndrome (psychotropic)

 * Latency: < 2 hours
 * Symptoms: hallucinations
 * Toxins: psilocybin, psilocin
 * Treatments: sedation, administration of diazepam
 * Prognosis: good
 * Notes: do not administer antibiiotics
 * Examples of fungi: fungi of Psilocybe genus

Mycoatropin-Neurotoxic Syndrome (muscarinic)

 * Latency: < 3 hours
 * Symptoms: muscarinic symptoms - sweating, lacrimation, miosis, convulsions, jaundice, diarrhea + other gastrointestinal symptomes → develops into anticholinergic symptoms - mental excitation, dryness of the skin, tachycardia, hallucinations, alternation of euphoria and depressions...
 * Toxins: muscimol, ibotenic acid, muscazon
 * Treatment: gastric irrigation, oral administration of active charcoal, symptomatic cares.
 * Prognosis: relatively good,
 * Notes: do not administer diazepam, atropine, barbiturates
 * Examples of fungi: fly agaric (Amanita muscaria) and panther cap (Amanita pantherina)

Gyromitrin-Hepatotoxic Syndrome

 * Latency: 6–12 hours
 * Symptoms: cephalea (headache), convulsions, jaundice, diarrhea + other gastrointestinal symptoms
 * Toxins: gyromitrin
 * Treatment: gastric irrigation, oral administration of active charcoal, adjustment of metabolic acidosis, intravenous administration of pyridoxine, symptomatic cares
 * Prognosis: uncertain
 * Notes: possible to be intoxicated by inhalation
 * Examples of fungi: Gyromitra esculenta

Phaloid-Hepatorenal Syndrome

 * Latency: 6–24 hours
 * Symptoms: gastrointestinal symptoms, hepatorenal failure
 * Toxins: amatoxins (thermostable cyclic octapeptides) amanitin and phaloidín
 * Pathogenesis: toxins are taken up by the liver, and subsequently excreted with bile. The toxins are reabsorbed via enterohepatic circulation. Once the toxins enter the cells, they bind to RNA polymerase, and inactivate it, causing a halt of proteosynthesis, → after already formed proteins are naturally degraded till certain point, it results in cell death
 * Treatment: vomitting, gastric irrigation, massive dose of active charcoal (1g/kg/2-4 hours), administration of silibinin (inhibits the cellular uptake of amatoxins), hemodialysis/hemoperfusion, complex supportive care (fluid reimbursement, substitution of coagulation factors, glucose with insulin); the last treatment option is a liver transplantation.
 * Prognosis: poor (death within a week from circulatory failure or septic shock), survival rate is 10-20%.
 * Notes: 85% of amatoxins are excreted unchanged by kidneys. The kidney damage is rather caused by dehydration (even during therapy it is necessary to maintain water and electrolyte balance)
 * Examples of fungi: death caps (Amanita phalloides), fool's mushroom (Amanita verna, it is often confused with ones of Agaricus genus, parasol mushroom, St. George's mushroom)

Antabus Syndrome

 * Latency: 6–24 hours
 * Symptoms: sweating, cephalea (headache), tachycardia.
 * Toxins: coprine
 * Treatment: symptomatic care
 * Prognosis: good
 * Notes: symptoms occur only after the ingestion of alcohol.
 * Examples of fungi: common ink cap (Coprinopsis atramentaria)

Orellanine-Nephrotoxic Syndrome

 * Latency: 36 hours –17 days
 * Symptoms: gastrointestinal symptoms, cephalea (headache), convulsions, oliguria, acute renal failure
 * Toxins: orellanine
 * Treatment: hemodialysis
 * Prognosis: poor
 * Notes: long latency!
 * Examples of fungi: fool's webcap (Cortinarius orellanus)

Related Pages

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