Mushroom Ingestion (ER Story)

Jack Denver brought his daughter Kate to the emergency room when she put a wild mushroom in her mouth. He says, “We weren’t sure if it was poisonous, so we thought we needed to seek medical attention.”

Kate was playing in the backyard when she found it. Jack says, “We were watching her closely, but kids are quick and she just put it right in her mouth. We caught it probably within 20-30 seconds.”

At 10 months old, Kate is starting to put everything in her mouth. Dr. Kathleen Nelson says, “They become much more mobile with the crawling, and they become very precise with the pinch of grasp.”

In the United States there are more than five thousand kinds of mushrooms. Not quite a dozen are considered deadly. Dr. Nelson says, “You can get very sick and actually get liver failure with the ingestion of those kinds of mushrooms but those are not commonly found in the garden. They are in the woods under logs.”

Mushrooms found in the backyard are not usually poisonous, but they can still make you sick. Dr. Nelson says, “They can irritate. So signs of irritation would be excessive drooling, nausea, vomiting.”

Kate seems to be fine. But if your child eats a wild mushroom, Dr. Nelson says, “I think it is quite appropriate if you can to retrieve the mushroom, and bring it with you when you go to the emergency room or the doctor’s office. If this happens to you with your child, call the doctor right away. Don’t wait for symptoms to occur, call right away.”

During an emergency, you can call poison control at 1-800-222-1222. That number works from anywhere in the country.

There are 5,000 different types of mushrooms growing in the United States, and around 100 of these account for most of the reported mushroom poisonings. Unless you are a mushroom expert, it is very unlikely that you will be able to identify the differences between poisonous and non-poisonous mushrooms growing in the wild. While children should never eat mushrooms in the wild, experts at the American Academy of Family Physicians say the following may signify poisonous mushrooms should your child ever ingest one:

• Warts or scales on the cap, or top, of the mushroom
• Gills that look like thin, leaf-like plates on the underside of the cap
• Gills that are white or light-colored, not brown
• An upper ring around the upper part of the stem
• A lower ring around the lower part of the stem
• A bulb-like base of the stem

There are signs to watch for if you suspect your child has eaten a wild mushroom. These symptoms may take several hours and even days to become evident, however, so seek immediate medical attention if your child has swallowed wild mushrooms. Experts at the California Poison Control System have developed the following list of symptoms, broken down into groups:

• Group 1: Cyclopeptides – The first signs and symptoms may not develop for six to 24 hours, usually 10 to 14 hours after the ingestion. Symptoms begin with sharp abdominal pains, followed by violent vomiting and persistent diarrhea, which often contains blood and mucous. In three to four days, the patient begins to worsen with symptoms of kidney and liver failure. Death is very possible.
• Group 1a: Orellanine – Symptoms begin 36 hours to 11 days after ingestion. They include nausea, lack of appetite, headache, and, most importantly, a severe burning thirst and kidney failure.
• Group 2: Ibotenic Acid-Muscimol – A state resembling alcohol intoxication develops 30 to 60 minutes after ingestion. Confusion, muscle spasms, delirium and visual disturbances, which last for about four hours, develop following the intoxicated state. Vomiting usually does not occur. Drowsiness and sleep follow and recovery is usually rapid.
• Group 3: Monomethylhydrazine – After six to eight hours, the patient experiences a feeling of fullness in the stomach followed by vomiting and watery diarrhea. Headache, fatigue, cramps and intense pain in the liver and stomach regions occur, followed by jaundice. Seizures occur in severe cases.
• Group 4: Muscarine-Histamine – Within 30 minutes to two hours after ingestion, symptoms include sweating, drooling, diarrhea, watery eyes, blurred vision, pinpoint pupils, decreased heart rate and blood pressure, and asthmatic breathing. (The sweating, drooling, diarrhea and watery eyes do NOT occur with other types of mushroom poisonings.)
• Group 5: Coprine – Symptoms only usually occur if alcohol is consumed within the five days following mushroom ingestion, which will likely not be the case with your child. However, flushing of the face and neck, a metallic taste in the mouth, numbness of the hands and feet, palpitations, and an increased heart rate are the symptoms.
• Group 6: Psilocybin-Psilocyn – These are the hallucinogenic mushrooms that alter consciousness. An intoxicated or hallucinogenic condition begins between 30 and 60 minutes after ingestion. The mood may be apprehensive (anxious) or pleasant. The person may experience compulsive movements and uncontrolled laughter. In children, a high temperature (102°F to 106.5°F) with seizures may develop.
• Group 7: Gastrointestinal – Within 30 to 90 minutes of ingestion, sudden severe vomiting and mild to severe diarrhea with abdominal cramps occurs. Symptoms generally last six hours. In children, this may lead to dehydration severe enough to require hospital treatment.

Remember, it is pertinent to get immediate medical help if you believe your child has ingested wild mushrooms, whether the symptoms are present or not. Mushroom poisoning is like any other poisoning, so erring on the side of caution is recommended.

American Academy of Family Physicians
California Poison Control System
Driscoll Children’s Hospital