Mushroom Poisoning - Symptoms, Treatment. Which Mushroom is most common and dangerous?

There are approximately 100000 known fungi species in the world, but only about 100 of these are toxic to humans.
Mushroom poisoning commonly is mild. But sometimes it causes death.
Poisonous mushrooms are eaten by mushroom hunters out of ignorance, after misidentification as edible mushrooms.
Most people are not able to tell which mushrooms species are safe for consumption.
Also, certain people seek psychotropic mushrooms to get a “high”, but mistakenly ingest poisonous mushrooms.
Normally, the cases of poisoning are rare, as commercially obtained mushrooms. Because they are grown under well-controlled conditions.
Most important species of mushroom you should know is, Amanita species, because, they are responsible for the majority of mushroom toxicity cases in humans.

And most important mushroom toxin you should know is, Amatoxin.
Because, Ninety-five percent of deaths, from mushroom ingestions worldwide, are from amatoxin-containing mushrooms.
Amatoxin Causes often fatal liver damage 1–3 days after ingestion.
The Amatoxin toxin is heat stable, remaining toxic whether eaten raw or cooked.
So it doesn’t matter if person ingest raw or cooked amanitin, it still stays poisoning.

The mechanism of action of amatoxin is by inhibiting RNA polymerase, causing disruption of transcription of mRNA. As a result, hepatocytes cannot synthesize key protein coding genes, leads hepatic centrilobular hepatic necrosis.
This leads to the insidious onset of liver failure over 48 hours and death.
Amatoxin poisoning doesn’t always causes death. Death rate is 10-15 % of cases.

The Amanita mushrooms contain both amatoxins and phallotoxins.
Second toxin; Phallotoxin is not lethal but, Causes extreme gastrointestinal upset like vomiting and watery diarrhea
Amanita poisoning clinical picture:
First Phase is silent. No symptoms until 6 to 12 hours after ingestion.
Symptoms begins to occur after 6 to 12 hours.
Nausea, abdominal cramps, profuse watery diarrhea, and signs of dehydration are common.
A physical exam may reveal dry mucosal membranes and tachycardia, and given sufficient dehydration, hypotension.
After abovementioned phase, the second stage appears where the patient appears to recover transiently, and gastrointestinal symptoms resolve, but ongoing liver damage continues. This stage may last two to three days and is characterized by rising liver function transaminase, bilirubin, the development of coagulopathy, and eventually hepatic encephalopathy.

Some mushrooms doesn’t, contain Phallotoxin but contains amatoxin. At this case symptoms like, diarrhea and vomiting occurs late.
And first symptom you may see, is liver failure symptoms. Such as nausea, vomiting, confusion, yellow skin.
Amatoxins sometimes damages kidneys and causes renal failure.
When renal failure occurs, dialysis should be used, but its use even early after an ingestion does not remove Amatoxin from the blood.

The prognosis is dependent on the mushrooms ingested and the amount of time it takes to seek care.
But Death is rare, if treatment is started immediately, and although fatalities continue to be reported, they occur in less than 5%, of all cases in developed countries.

Diagnosis is made by symptoms. Plus rising liver transaminases within two to three days of foraging for mushrooms.
Treatment:
1. N-acetyl-cysteine: Used intravenously, as per acetaminophen poisoning to treat potential liver injury, and provide glutathione.
2. Penicillin: High dose intravenously; (four million units every four hours). is thought to compete with the liver uptake of the amatoxin.
3. Silybum marianum or blessed milk thistle; has been shown to protect the liver from amanita toxins, and promote regrowth of damaged cells.. Its mechanism of action is felt to be an OAT-P transporter inhibitor that slows the entry of amatoxin into the liver. Doses are 1 gm orally four times daily, or its purified alkaloid silibinin. intravenously 5 mg/kg over one hour, followed by 20 mg/kg/day as a constant infusion.
4. Activated charcoal: May reduce absorption of amatoxins if given early after ingestion and may also prevent toxin readsorption hours later as amatoxins undergo enterohepatic recirculation. A dose of 1 g/kg may be given every 2 to 4 hours.