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Mushroom Poisonings Reported in 2004
By Michael W. Beug, Ph.D., Chair
North American Mycological Association Toxicology Committee

In 2004 the mushroom season in the western half of the United States was exceptional, with record fruitings of many species. With a record abundance of mushrooms and an increased interest in the harvest of edible wild mushrooms, there was an associated increase in the total number of poisonings from the western half of the United States. The overwhelming majority of reports that I have received over the past year have again come via the work of Marilyn Shaw of Denver, Colorado. Most of her reports result from her close cooperation with the Rock Mountain Poison and Drug Center ((RMP&DC). She also frequently met with people involved with the poisonings in order to more accurately understand what mushroom might have caused the poisoning. Hanna Tschekunov provided reports from calls to the Florida Poison Information Center Network. Judy Roger investigated mushroom poisoning reports from the Oregon Health Sciences University, Oregon Veterinarians, and from the Oregon Mycological Society Website. Judy regularly went to the site of the poisoning to collect mushrooms and frequently was able to do microscopy from the vomitus of the victims to positively confirm most of her identifications. Raymond Archambault provided information about poisonings in the Québec area. Information about any poisonings that may have occurred in the rest of the United States continues to be very sparse and comes as a result of concerned individuals locating the NAMA website or contacting the author through his mushroom website. In other cases (California) reports were gathered largely from the newspaper and are quite incomplete.

This report covers 148 individuals including about 40 children and adolescents plus 51 dogs. This year, for the first time in several years, there were reports of human deaths from mushroom ingestion. There was one death reported from ingestion of Amanita bisporigera, one from Amanita virosa and one death reported from Amanita phalloides. These mushrooms contain amatoxins. There may also have been a death due to kidney failure from a man in California collecting "Boletes." Eight dogs died or were euthanized after mushroom consumption. It is important to note that over half of the human poisonings by Amanita spp. involved Asian immigrants (cases in Oregon, California and Minnesota). Several other poisonings also involved recent immigrants from various parts of the world where mushroom collecting is practiced. There is clearly a need to find a way to educate recent immigrants about dangerous look a-likes to mushrooms that they are familiar with from their home country. In many Asian countries, Volvariella spp.are abundant. These pink-spored mushrooms look very similar to the white-spored "Destroying Angels", especially when young and the pink spores are not yet in evidence. In the past Italian immigrants have consumed Amanita phalloides, mistaking it for the choice edible "Coccora", another Amanita with a distinct cup-like volva. One person likes to eat amanita vaginata and got Amanita phalloides instead. People mistook Amanita pantherina and Amanita muscaria as well as Chlorophyllum molybdites for an amazingly wide range of edible mushrooms. Indeed, I suspect that many of the "unknown" poisonings from Florida were due to ingestion of Chlorophyllum molybdites.

The patient age is given where known since mushroom toxins frequently have a more adverse effect on the very young, the elderly and the infirm. I have also included any known information about other health issues that the person may have been suffering. This is very challenging since patient confidentiality rules have left doctors and hospitals very unwilling to give out any information, even though for our purposes we have no interest in the identification of the individual. The importance of knowing about underlying health issues stems from reports in the fall of 2004 of at least thirteen deaths in Japan, all associated with the consumption of Pleurocybella porrigens, "Angel’s Wing". All of the individuals who died (of an acute brain condition) had kidney disorders. Since "Angel’s Wing" is common in the United States, it is important to alert mushroom pickers to its potential danger to people on dialysis. However, I have no record of this species ever causing a poisoning in North America. I have eaten it occasionally and have once or twice served it to my mycology students over the years, but it is not that great tasting and it is now off of my list.

In a number of cases, the poisoning involved a popular edible species. Most of these cases are examples of individual food sensitivities. However, as in years past, a number of people became ill after eating morels – some in association with alcohol, but some where no alcohol was involved and the mushrooms were thoroughly cooked. In some of these cases "False Morels" which I presume to be either Verpa bohemica or Gyromitra esculenta are suspected. There is actually a significant commercial market for Verpa bohemica and many people relish eating it! Others react strongly to Verpa spp. and/or to Morchella spp. There were also two reports of poisonings from consumption of the choice edibles Cantharellus formosus and one human and one dog report from Tricholoma nudum. Members of the Armillaria mellea complex growing on conifers also caused several poisonings.

In the compilation that follows, I have grouped reports by mushrooms species and give a brief overview of the number and age of individuals involved and the range of symptoms observed. Treatments are noted when reported. The identification of the mushroom species involved is sometimes just an educated guess, often done by people at the hospital from pictures on web sites but wherever possible the actual mushrooms involved in the poisonings were examined by a professional mycologist or another competent identifier. Cases involving dogs are grouped at the end of this report. Unusual features of the poisonings are in bold. Reports of earlier poisonings, not previously recorded, notably a group of reports from Québec are identified by month and year of the poisoning.

<>The Mushroom Poisonings

Agaricus spp. Case 1: Idaho, two children age 6 and unknown age, each ate 2 large bites of a large, white, rapidly yellow-staining mushroom under a pine tree. Both began vomiting in 10 minutes. Vomiting in one continued for about 2 hours. Case 2: Idaho, male, 7, ate unknown amount of mushroom from grass in yard. Two hours later began vomiting (2x). Field identification was Agaricus xanthodermus.

Amanita bisporigera. (August 2003): Québec, male, 56, ate mushroom cooked for food. Ten hours later symptom onset involved diarrhea, vomiting, nausea, intestinal cramps, sweating, vomiting and weakness. Treated with activated charcoal every 4 hours for 72 hours with remission of the hepatic symptoms observed. Case 2: Minnesota, a man, 87, became ill 8 hours after eating mushrooms collected in a Minnesota park. His liver enzymes were found to be elevated and he died ("bled out") in about 2 days. The death, not from liver failure, was what Dr. Denis Benjamin postulates as "possible intestinal perforation, an uncommon and lethal complication of amatoxin poisoning" complicated by failure of the coagulation system.

Amanita muscaria. Case 1: Idaho/Montana border, two adults and 2 adolescents picked mushrooms they believed to be Matsutakes. They cooked and ate several mushrooms from a mixed collection, of which one species was Amanita muscaria. After 1 to 1.5 hours both children were vomiting and subsequently "crashed" and could not be roused. Mom felt drunk with a headache and weird dreams that lasted all night. The father was not appreciably affected. Case 2: Montana, adult couple, 47 and 44, ate a "Puffball with a little orange on top" that was as big as a grapefruit. They also ate 2 lemon sized ones and two smaller ones cooked in foil on a campfire. An hour and a half later both were feeling weird, uncoordinated, and had difficulty walking. They were dizzy and having wild dreams about mushrooms and one vomited 2x, the other 3x. They drove from camp to get help and recovered at home. Case #3: Idaho, man, 60 cooked and ate mushroom, then 30 minutes later while driving home felt nauseated and began vomiting. He soon resumed driving but nearly went off the road. He tried to walk but couldn’t stand up and fell, spraining an ankle and getting bumps and bruises. Was not concerned that he thought he was dead and was talking to his dead father. Was found by a friend on the side of the road and at the hospital was hallucinating, twitching, drowsy, alert one minute and "out of it" the next. Case #4: Washington, couple ate "Puffballs" that when cut showed a yellow ring around the edge. The woman ate just a little and experienced nausea and was "fuzzy headed". The man felt lightheaded and threw up violently 12 hours after ingestion.

Amanita pantherina. Case 1: Idaho, five male and female adults, 42 to 74, picked what they had identified as "Shaggy Manes" but had a mixed collection of Amanita pantherina and a smaller blue-gray mushroom. Within three hours one male began acting agitated and appeared to be hallucinating, soon at least 4 were affected and those four were hospitalized. They all were vomiting, had altered states, muscle twitching, some were agitated, then sleeping or comatose. One patient had a very low blood count. Case 2: Montana, two females and a male, 47-55. Two ate 2-3 caps each and a third had a few slivers. Symptoms after 3 hours included a night of vomiting followed by dry heaves in the morning, lethargy, exhaustion and headache. One reported hallucinations and one could not remember anything about the previous night. Case 3: Colorado, female, 80, and daughter each at 2 mushrooms that they had identified as Matsutake, well cooked in butter. Two hours later they went to the hospital and both fell asleep with muscle spasms. Older woman, a chronic acetaminophen user, had unexplained pinpoint pupils and could not be roused. She slept for 36 hours. Daughter slept for 6-7 hours with dreams she could not describe. Case 4: Colorado, woman, 54, picked "After Rain Mushrooms" and ate 10 large specimens for lunch (two of which appeared to have been panthers). After 1 hour she began to feel funny, spacey and took a 20-minute drive with her young son after which she was dizzy, staggering and her visual background was revolving like a kaleidoscope. She vomited once and had her son call 911. She became comatose at the hospital and nurses reported muscle spasms. She regained consciousness after about 12 hours. Case 5: Colorado, couple, 61 and unknown age, collected, cooked and ate an unknown quantity. Symptom onset 2-2.5 hours. Male vomited was agitated, showed signs of altered mental status, becoming unconscious, muscles twitching. Female described as catatonic. She awoke after 12 hours, still shaky, and reported strange dreams. Case 6: Colorado, adult female fried and ate three. After about 1.5 hours she felt drunk, dizzy, light-headed, hands "nervous", trouble focusing. She stayed at home and fell into deep sleep for about 6 hours. Case 7: Colorado, male, 22 months, found with dried out mushroom in hand but no evidence of ingestion and no symptoms

Amanita phalloides: Case 1: Oregon, 7 individuals, male and female, 24-40, who speak little English were poisoned. They ate a moderate amount at one meal cooked in a casserole. Symptom onset was 8-12 hours. Some ate more than others and were sicker. They suffered diarrhea, dizziness, fever, intestinal cramps, nausea, sweating, vomiting and weakness. Their liver enzymes were severely compromised. One had liver shutdown and kidney involvement and recovered much slower than the others. Two individuals were treated with IV fluids and released. For five individuals treatment was with IV fluids, silymarin, hemodialysis. They all gradually recovered. Collectors thought they had picked a Volvariella species "just like in Korea". Case 2: California, 4 adults from one family ate an unspecified amount of mushrooms macroscopically and microscopically confirmed to be Amanita phalloides. Some or all 4 came to the hospital the day after they first ate the mushrooms and "were given some medicine" and sent home. One returned the following day and when the physician found that mushrooms had been consumed summoned the other three to return. Four days after the first meal of the mushrooms one woman, 70, was dead, one was in critical condition, one was improving and a fourth had been discharged. The woman who died ate the mushroom at 2 meals. Case 3: Washington man, 47, ate the cap and part of the rest of one mushroom at one meal for food. Symptom onset was 8-10 hours but he waited an additional 12-14 hours to get help. He had diarrhea, dizziness, high fever, intestinal cramps, nausea, sweating, vomiting and weakness. He was near coma when brought in. His liver and kidneys shut down completely. He later went into a coma and had a blood infection. He was placed on full life support and given hemodialysis. Four and a half months later he is still in a nursing home, still very weak and too ill to care for himself with his kidneys at about 80% function, liver still compromised, but blood infection nearly gone. He thought that he had eaten an Agaricus. The entire mushroom that he had was consumed and nothing was available to confirm the identification, but the symptoms and blood workup was consistent with Amanita phalloides. Case 4: Oregon, man, 35, ate about 2 caps for food, possibly in more than one meal. The onset of symptoms was about 8 hours. He suffered diarrhea, dizziness, severe headache, intestinal cramps, nausea, sweating and vomiting. Blood work showed kidney/liver damage and compromise. He was treated with fluids and silymarin and recovered quickly as he came in as soon as he suspected what he ate. He thought he had a very pale Amanita vaginata. It had been raining for several days and many of the specimens collected later identification had bleached nearly white. He said that he ate from the amanita vaginata group fairly often.

Amanita virosa. Case 1: (Sept 2003) Québec, woman age 19 ate 1 bite raw, immediately realized that she had made a mistake and went to the hospital where she was treated 4x with activated charcoal at 4 hour intervals. She remained asymtomatic. Case 2: Québec. Man, 61, ate an unknown amount of cooked mushrooms for lunch. The symptom onset was 12 hours and he suffered typical amatoxin symptoms. There are no details of his treatment. Death occurred Sept 2, 2004, 5 days after ingestion of the mushrooms.

Boletes? A man in the San Francisco Bay Area who thought he was collecting Boletes suffered renal failure and reportedly died. No other information is available.

Armillaria mellea complex. Oregon. Several people contacted the Oregon Mycological Society website complaining of gastric upsets, cramps and/or diarrhea. All but one of the calls was checked out by examining mushrooms from the same clump. All were found on conifer logs or stumps. The exact number of people with these symptoms was not given in the report. One couple who had eaten the "Honey Mushroom" previously ate a fair amount this time. They suffered diarrhea, intestinal cramps, nausea, vomiting and a bit of flushing. They just felt miserable and were treated with charcoal and fluids after which they quickly recovered.

Boletus edulis. Colorado, male, 61, and female, 51. Female, who has Crohn’s disease developed nausea, vomiting and diarrhea within 15-20 minutes. Male suffered nausea and vomiting commencing 1 hour after ingestion.

Cantharellus formosus. Case 1: Washington, male, 50, purchased a pound of Yellow Chanterelles in good condition at a roadside stand and ate one large one (no alcohol involved). Several hours later he experienced hallucination and weakness, becoming completely disoriented, with imagined visits and conversation. He slept with troubled dreams and awoke tired but with a clear head. The mushrooms were later positively identified as Chanterelles. Case 2: Oregon, female ate a fair number cooked in a sauce. She drank no alcohol with the meal and began to feel ill after 2-3 hours. She suffered diarrhea, intestinal cramps and vomiting. She was treated with charcoal and recovered rapidly. She had eaten these many times before without adverse effect. The four or five other people who shared the meal were not made ill by it.

Chlorophyllum molybdites. Case 1: Hawaii, two children, 4 and 6, each ate one bite. Charcoal was administered and there were no symptoms. Case 2: Hawaii, two males, 14, each took a taste. Three hours later one was vomiting, the other had no symptoms. Case 3: Hawaii, female, 56, no symptoms reported from cooked specimens. Case 4: Colorado, male, 14, picked what appeared to be Agaricus arvensis and what appeared to be Chlorophyllum molybdites. He cooked and ate two slices of the latter. After 2.5 hours, vomiting began and continued 9 times over next 2 hours. The father also ate some and got sick later. Case 5: Colorado, males 14 and 12, and female, 6, ate pieces of mushroom collected from a lawn identified as "horse mushroom" by their grandfather. Two hours later all three were sick with vomiting and diarrhea. Grandfather who ate only a very small amount was not affected. Children all given charcoal in hospital but could not keep it down so were put on IVs. The 12-year-old had blood in feces and vomit. Case 6: Colorado, female, 64, ate 3 whole, cooked 1-2 minutes (mixed collection of Agaricus sp. and Chlorophyllum molybdites). After 30 minutes vomiting (3x) and diarrhea (2x). Headache the next day. Case 7: Colorado, female, 6, ate mushroom growing in grass. Within 2 hours she was vomiting (2x). Case 8: Colorado, male, 30s, ate ½ cap. Vomiting (3x) began after 1.45 hours associated with a bloated feeling. Case 9: Hawaii, female, 45, stir-fried and ate mushroom. After ½ to 1-hour vomiting and diarrhea began, lasting 1 hour. Case 10: Hawaii, couple, 42 and unknown age, ate one very small mushroom raw -– ¾ eaten by husband, ¼ by wife. Nausea, vomiting and diarrhea began 6 hours later.

Clitocybe sp. See mixed ingestion.

Suspected Gomphus floccosus. West Virginia, adult female thought she had collected Cantharellus minor. Nine hours after ingestion she suffered abdominal pain and began vomiting. Cramps were sporadic for 24 hours.

Gymnopilus liquiritiae. Japan, male, 35, consumed the mushrooms with beer for recreation. No mention is made of the hallucinations expected from "The Big Laughing Mushroom". However, 12 hours later he began to feel queasy and lost his appetite for 24 hours. Then for the following week, he wanted to sleep 10-12 hours a day plus needed naps and had trouble concentrating. After a month, periods of anxiety would start. He would drink alcohol and then a few hours later would suffer intense anxiety, chills, tingling extremities, and a kind of inebriation. After 3 months this is happening less frequently and with diminished intensity.

Inocybe geophylla. (November 2003) Québec, adult male ate several species including this muscarine-containing mushroom. Physician recognized and successfully treated the classical muscarinic symptoms.

Ipecac. Colorado, female, 5, ate a mushroom from the yard and within 5 minutes the parents administered ipecac which soon induced vomiting. All of the mushrooms in the yard appear to have been Marasmius oreades.

Laetiporus sulphureus. Wisconsin, male, 23, cooked and ate about ½ to ¾ cup. Fourteen to 18 hours later he experienced dizziness and a severe contact dermatitis (poison ivy-like) over most of his body with discomfort and blistering. Treatment with prednizone led to slow recovery over several weeks. To confirm that the mushroom caused this, the patient later cooked and ate one very small piece. After 12-15 hours small irritated patches of skin were noticeable.

Leccinum manzanitae. California, a young woman ate several dried, salted manzanitae "chips" and suffered significant gastro-intestinal distress. Many others had eaten the same chips without ill effect.

Leccinum sp. An Oregon man ate an unspecified number of Leccinums, leaving just one blackened stipe for the identifier. He suffered severe cramping and diarrhea.

Lentinula edode. Female, 54, ate ½ of a purchased mushroom, cooked for food. Alcohol was consumed. After 4.5 hours she experienced chills, dizziness, disorientation, spasms, vomiting, drowsiness, weakness, headache followed by difficulty breathing and unconsciousness within 20 minutes of symptom onset. Emergency room treatment included oxygen and IV fluids with recovery after several hours.

Lepiota americana. Male and female twice ate mushroom, listed as edible and choice, and felt a very unpleasant mild to strong peppery sensation in their throat, lasting 4-6 hours.

Leucoagaricus leucothites. Case 1 (August 2003): Québec, male, 35, ate 1 raw for recreation. 6 hours later he suffered Diarrhea, intestinal cramps, nausea and vomiting with acidose respiratoire and recovered with rehydration treatment. Case 2: Adult male and female ate a number of mushrooms in a stew. Wife had no ill effects. Husband reported "after a couple of days my body was covered by a sort of pruriginous allergic reaction, most disturbing and resisting the usual treatments therefor, which lasted for a week at least and on hands and feet is still on."

Mixed Ingestion. Case 1: Montana, two adult males and a female collected "Elephant Ears" and ate "a lot". About 3 hours later they began to experience vomiting, diarrhea, and stomach cramps. E-mailed photos show a Ramaria sp. and a large Clitocybe sp. Case 2: Adult male ate Lactarius hygrophoroides and "Hen of the Woods", both thoroughly fried. After 2.5 hours he experienced nausea and acute gas followed by flu-like symptoms 24 hours later.

Morchella spp. Case 1: Colorado, male, 26, rehydrated a handful of dried morels and cooked them for 10 minutes. They were consumed with 4-5 beers. Symptoms began at 1:30 am and included prolonged vomiting, chills, back and leg pain (no spasms), weakness, aching (no headache). Some had been eaten a week earlier along with wine and there was no problem then. Case 2: Montana, male, 25, and neighbor ate what they identified as morels. Patient ate one raw that night followed in 4 hours by vomiting. Neighbor cooked and ate a lot the next morning and also started vomiting 4 hours later. Case 3: Montana, male, 42, ate 6-8 cooked mushrooms of which some seemed to be morels, some were questionable, no alcohol. Vomiting, abdominal cramps, diarrhea, and sweating began 2 hours later and continued for at least 3 hours. Activated charcoal was given at the hospital. Case 4: Montana, female, 72, purchased morels or false morels at a farmers market. About 3 – 3.5 hours later she began vomiting (5-6x). No other symptoms. Case 5: Washington, male, 31, ate 5 cooked (no alcohol involved) and 1 hour later had onset of serious vomiting and diarrhea accompanied by weakness, nausea and dizziness

Omphalotus illudens. (Sept 2003): Québec, six adult females ate about 100 grams cooked for food. In 15 minutes all started to suffer drowsiness, dizziness, headache, intestinal cramps, nausea, salivation, sweating, and vomiting. All were treated with rehydration therapy and recovered.

Pleurocybella porrigens (reports from Japan): A total of 48 people in Japan reportedly developed a "brain condition" after eating "Angel’s Wings", known in Japan as "Sugihiratake". Thirteen died. All had impaired health prior to eating the mushrooms and all were on Kidney Dialysis. The common symptom was dizziness and the cause was acute encephalopathy

Suspected Pleurotus sp. Michigan, female, 3, ate some raw in an apparently deteriorated condition. Five hours later the child experienced fever, vomiting, nausea and was drowsy.

Psilocybe cubensis. An individual suffered a bad trip with this hallucinogenic species, but no details are available.

Ramaria sp. (see mixed ingestion)

Tricholoma nudum (Lepista nuda). Washington, a retired physician with a few food allergies (to cherries, some plums and hazelnuts) and his wife picked blewitts from their back yard and fried them in butter for lunch. Fourteen hours later he was awakened with upper abdominal (transverse colon) cramps, and explosive watery diarrhea for a couple of hours followed by a quick recovery. The delayed timing did not tie the event to the mushrooms until a few weeks later when a fresh crop of blewitts appeared. Eleven hours after the second ingestion, he awoke with headache and malaise, followed in another hour by violent explosive diarrhea. Intermittent diarrhea and occasional cramps persisted this time for 60+ hours. His wife was unaffected on both occasions. I have positively identified the mushrooms.

Tricholoma saponaceum (and Tricholoma flavovirens). Idaho, seven males, most 20-40, one 76 and one female, 72, consumed a mixed collection (identified by Dr. Orson Miller) and 1 hour later began to experience severe vomiting and diarrhea, even affecting the cook who had had just a taste.

Unknown hallucinogenic. Case 1: Hawaii, Two males, 17 picked and ate a handful of mushrooms from a cow pasture. After one hour, one was experiencing the expected visual distortions but the other experienced palpitations and was anxious. Case 2: Florida, female, 21, ate unknown mushrooms cooked in foil and seemed to have a seizure and pass out. She was treated with charcoal, given supportive care. Liver and kidney functions were normal. Case 3: Florida, woman in her 30s consumed a psilocybin mushroom for recreation and was admitted to non-critical care unit where she was treated with a single dose of activated charcoal and IV fluids. Case 4: Florida, woman in her 60s ate an unknown hallucinogenic mushroom (white, 7 cm diameter – Psilocybe cubensis? or did she get Chlorophyllum molybdites?) for recreation. Symptoms included vomiting and a slightly lowered heart rate. She was treated with a single dose of charcoal and IV fluids and kept overnight. Case 5: Florida, male, 16, ate unknown mushrooms for recreation at a party and suffered confusion, hallucinations/delusions and other related symptoms. He was given a single dose of activated charcoal and other supportive treatment and admitted to ICU. Recovery after 8 hours. Case 6: Florida, male 29, ate an unknown mushroom from his backyard for recreation and vomited once. He was given a single dose of charcoal and supportive treatment. Case 7: Florida, male 20, experienced hallucinations/delusions after eating a mushroom growing in cow manure. He was given a single dose of charcoal and supportive care and discharged in about 8 hours. Case 8: Florida, male 17, ate a bite of an unknown white mushroom and was asymtomatic. He was given a single dose of charcoal and observed for 12 hours, then discharged. Case 9: Florida, male, 19, ingested some mushrooms and was hallucinating and had other unspecified symptoms. No other information was available. Case 10: Florida, male, 23, consumed unknown hallucinogenic mushrooms along with heroin and XTC (slang for MDMA). Patient had hypertension, tachycardia, fever, and was agitated/irritable. His pupils were constricted. Case 11: Florida, male, 19, had ingested mushrooms 5 days previously to get high and still feels "fuzzy-headed" and still hallucinating. Case 12: Florida, man, 32, "took a bite of a hallucinogenic mushroom". Suffered diarrhea, nausea, vomiting. Patient given dose of charcoal and IV rehydration. Case 13: Woman, 21, consumed hallucinogenic mushrooms and marijuana and was hallucinating. Given dose of charcoal. Case 14: Florida, male, 15, ate about 10 mushrooms from a cow pasture and became agitated/irritable with tachycardia. Patient treated with single dose of charcoal and IV fluids. Admitted to ICU for monitoring for 8 hours. Case 15: Florida, female, 18, consumed 16 pills of Coricidin HBP (Cough and cold pills) plus psilocybin mushrooms at her school. She was fidgety and grabbing things in the air that are not there. Patient did not seek treatment.

Unknown purchased "hallucinogenic". Denver, three teenagers purchased and consumed raw shredded brown mushrooms. One to four hours post ingestion they experienced vomiting, diarrhea, abdominal pain and a little tachycardia, but no hallucinations, just an emergency hospital bill.

<>Unknown. Case 1: Idaho, 4 adults collected and ate unidentified wild mushrooms. Female patient began vomiting three hours later. Others had no symptoms. Case 2: Montana, three adults, a male and two females, 31-57, cooked and ate a mushroom that they identified as "The Prince", Agaricus augustus. Male also consumed a glass of wine and about 1 hour later felt drunk, dizzy, bloated, and nauseated. One female was dizzy and nauseated. Second female was nauseated and vomited (2x). Case 3: Colorado, female, 40, ate 4 raw, small mushrooms from her yard. After about 1.5 hours she experienced drooling, nausea, and hot and cold flashes. Case 4: Nevada, female, 14 months, ate a bite of a quarter-sized mushroom and vomited 2x. Case 5: Idaho, male, 3, ate a mushrooms and when RMPDC was called 2 hours later he had vomited several times. Case 6: Idaho, woman, 50, ate dried "Honey Mushroom" on a pizza. An hour later she did not feel well and 5 hours later was vomiting, had diarrhea, headache and shaking. Case 7: Pennsylvania, male, 48, ate two small mushrooms ("False Morels"?) for food accompanied with alcohol. In ½ hour started to suffer cramps sweating, vomiting, nausea and weakness. Given charcoal and symptomatic treatment for diarrhea and vomiting. Case 8: Florida, woman 87, and one other person each ate one white mushroom from a lawn for food. One hour later she started suffering diarrhea and called Florida Poison Information Center Network. Case 9: Florida, two individuals found a huge white mushroom in the backyard and ate it. Both developed gastrointestinal symptoms within the hour and went into dry heaves. Case 10: Florida, boy, 5, ate a mushroom from his yard. No reported symptoms or treatment. Case 11: Florida, male, 33, had a taste of a mushroom and several minutes later suffered vomiting, dizziness, and nausea. He was given a single dose of charcoal and supportive treatment. Case 12: Florida, female, 12 months, found with a mushroom with a missing piece. She was treated with one dose of charcoal and had no adverse effects. Case 13: Florida, male, 4, ate a piece of mushroom. He was given one dose of charcoal and watched for several hours, then discharged. Parents returned with the mushroom several hours later after the child had vomited. Mushroom identified by ER staff as "The Prince". Case 14: Florida, female, 62, experienced in collecting in Germany ingested a mushroom she had identified from a German book and suffered diarrhea, nausea, vomiting. She was treated with charcoal and given fluids and supportive care. Discharged after 24 hours. Case 15: Florida, male, 13 months, ate some black mushrooms growing on carpet (after the hurricane). No ill effects. Case 16: Florida, male 30, consumed mushrooms at a restaurant and felt nausea, abdominal pain. He was advised to drink fluids and stay hydrated and that symptoms not necessarily due to the mushrooms. Case 17: Florida, male, 19 months, ate a mushroom from near a tree in his yard. No symptoms, but treated with a dose of charcoal and observed for 4 hours, then released. Case 18: Florida, male, 32, experienced vomiting (2x) and diarrhea after eating some wild mushrooms in a park. Patient was treated with antiemetics, a single dose of charcoal, and supportive care. Case 19: Florida, woman, 32, suffered abdominal pain, diarrhea, nausea, vomiting 20 minutes after eating an unknown mushroom in her back yard. Treated with IV fluids. Case 20: Florida, male 40, was admitted to ER after consuming a herbal/natural product containing some type of mushroom. He suffered abdominal pain 1 hour after ingestion. Case 21: Florida, male, 52, ate some mushrooms from his yard. He suffered abdominal pain, vomited a lot and experienced tachycardia of 120s to 130s. Treated with activated charcoal and supportive care, MD was advised not to use physostigmine. Case 22: Florida, man, 22, suffered abdominal pain, diarrhea, nausea and vomiting 2 hours after eating an unknown mushroom. He was treated with a single dose of charcoal and given IV fluids.
Poisonings of Dogs

Amanita muscaria or Amanita pantherina. (Except where noted, all cases are reported from Colorado) Case 1: Dog of unknown age or breed showed agitation, staggering, panting, vomiting, muscle spasms, coma-like sleep lasting 12 hours with seizures and agitation continuing for a while after awakening. Coughing and lethargy lasted a day or two. Cases 2-4: two adult dogs and a puppy all three showing same symptoms as in previous case. Amanita pantherina was fruiting in unprecedented numbers in the area. All were treated and recovered. Case 5: dog, 90 pounds, acting drunk, agitated, then could no longer stand. Treated and recovered after about 10 hours. Cases 6-10: Four dogs in one week were brought in to the vet with staggering, twitching, salivating, collapse and coma. All recovered. Case 11. The week after cases 6-10, the owners of a dog, 12, found it dead due to respiratory failure but there is no evidence of earlier symptoms or of mushroom ingestion so cause here is unclear. Case 12: Older yellow lab was found agitated, uncoordinated, twitching and having difficulty breathing 1 hour after being let outside. The dog was euthanized about 2-3 hours later. Cases 13-23: An intern at an animal hospital reported that they had treated about 10 dogs with neurological symptoms that all sounded like ibotenic acid/muscimol poisonings. Case 24: Puppy began staggering, vomiting, twitching, and then collapsed but remained conscious. Vet administered IVs. Case 25: German Shepherd, 53 #, 1 hour post ingestion started vomiting, diarrhea, slow heart rate, drooling, walking in circles, staggering, breathing erratically. The vet also observed pancreatitis and administered atropine 2x for very low heart rate. For a while the dog appeared dead but was fully recovered after 36 hours. Case 26: Vizsla, apparently ate a piece of stem and 3-4 hours later started to whimper and whine and was stumbling. She soon was frantically moving about, stumbling into walls and drinking lots of water, loss of depth perception, dilated pupils, high heart rate and panting. She recovered overnight at the vets after treatment with valium, charcoal, heavy sedation and an overnight IV. Case 27: Michigan, dog, 2, ate about 1 teaspoon of amanita muscaria and in 5-6 hours started to salivate, and was dizzy, sweating, disoriented, weak and unable to stand or hold his head up. Heart beat fast but steady, breathing labored. Vet administered Valium and took other unidentified measures. The dog soon stopped being restless, became limp and then slept for several hours and awoke weak. Next day the dog was recovered but extremely thirsty.

Gymnopilus sp. Dog sick and staggering as if drunk

Inocybe sp. Case 1: Colorado, dog suffered vomiting, pinpoint pupils, diarrhea, and profuse salivation. Case 2 (from 2000): Virginia, dog had clearly identifiable Inocybe lamellae in vomitus. It experienced 45 minutes "of acute vomiting, mucoid diarrhea, hyper salivation and altered mentation". It was found to have "gas distended bowel loops, was depressed and displayed significant abdominal discomfort… increased hematocrit, mild azotemia and elevated ALT and ALKP. Treated with activated charcoal and IV and recovered fully after 8 hours. Cases 3-8: Oregon, in separate incidents 4 Labrador retrievers, one poodle, one boxer, and one cocker/shi tzu ate either Inocybe geophylla or Inocybe lilicina or in one case an unidentified Inocybe (near lacera). All were treated with charcoal, some with IVs, and in some instances, with atropine where indicated. The poodle, cocker mix and one Labrador died of mushroom toxicity.

Possibly Ramaria pallida. Colorado, dog, 6 months, salivating, gagging, and having dry heaves.

Russula sp. Colorado, dog experienced vomiting and diarrhea a while after it was seen chewing on a red Russula

Scleroderma, probably cepa. Colorado, 15# Dog, 7 months, ate an earthball and vomited (4x) beginning 10 minutes after ingestion.

Tricholoma nudum. Oregon, A schnauzer became only slightly ill after consuming this mushroom.

Unknown. Case 1: New Jersey, dog, 7 months, suffered diarrhea, salivation, spasms, dizziness, disorientation, weakness and drowsiness accompanied by an uncontrolled bladder and shallow breathing. Recovered with vet treatment. Case 2&3: California, 2 puppies died from mushroom ingestion, few specifics given except that in second case puppy was euthanized after two transfusions failed to improve its condition – both puppies died in a region where Amanita phalloides was abundant this year. Case 4: Ohio, 9 month old yellow lab suffered major liver damage from unknown toxins and was euthanized. Mushrooms were growing in the yard in Southern Ohio, apparently including one of the destroying angel group of Amanita. Case 5: Florida, three dogs, 4, ate mushrooms from the yard with no more than a minor effect. Advised to follow Ipecac protocol (Note: Rocky Mountain Poison and Drug Center advises not to use Ipecac). Owner bought and administered charcoal from the drugstore at doses recommended by the pcc.

Case 6: Florida, dog found with pieces of black and pieces of white mushrooms in its mouth. No symptoms observed. Case 7: Florida, dog ingested mushrooms and suffered severe diarrhea and vomiting. Case 8: Florida, dog, 2, possibly had eaten mushrooms 2 days previously and was in liver failure and metabolically compromised. Case 9: Florida, dog ingested an unknown mushroom and suffered vomiting and diarrhea.

Unknown Hallucinogen. Florida, dog consumed at least 9 hallucinogenic mushrooms. Seemed sleepy, not itself. Caller refused to pursue the matter with a vet for fear of getting into trouble with her fiancé.

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