Family OK after eating poisonous mushrooms

January 6, 2009 5:03:55 PM PST
An East Bay family that fell ill after eating a homemade soup containing wild mushrooms they picked off a hiking trail was poisoned by the Bay Area's most common toxic mushroom, the "death cap," according to the medical director of the California Poison Control System.

A 72-year-old woman and her two grandchildren were treated at the University of California, San Francisco Medical Center after eating a soup made with Amanita phalloides, an extremely toxic mushroom that resembles a type of edible mushroom, UCSF Children's Hospital spokeswoman Kate Schoen said.

The woman and her family went hiking on the Dipsea Trail in Marin County's Mount Tamalpais State Park Dec. 28, harvesting the Amanita phalloides on the trail, Schoen said.

That evening, the grandmother made a soup with the mushrooms and later that night the family fell ill.

After initially receiving care in the East Bay, the grandmother and grandsons were referred to UCSF on Dec. 29, Schoen said.

The boys' mother was able to return to the trail when the three were admitted to the hospital to collect mushrooms for testing, confirming the type of mushroom they consumed.

The grandmother reported she was drowsy and cold, and all three patients had symptoms including vomiting, diarrhea and cramping, Schoen said.

The toxic mushrooms also put all three patients at risk for needing a liver transplant, Schoen said.

However, all three made successful recoveries. The woman was discharged over the weekend and the two boys were discharged Monday, exactly one year since a family of six was poisoned after eating wild mushrooms they had collected New Year's Day at Wilder Ranch State Park in Santa Cruz.

Five of the family members recovered from the 2008 case, while the family's grandmother was unable to recover and died 10 days after eating the mushrooms.

No antidote exists for mushroom poisoning, and various treatments are used in an attempt to combat toxins released by the fungi, said Kent Olson, medical director of the California Poison Control System.

"There isn't anything that's a proven treatment other than abstinence from mushroom eating," Olson said.

Olson said doctors sometimes use high doses of penicillin or other drugs to treat mushroom poisoning and often use charcoal to prevent toxins from being fully absorbed.

A German drug, silibinin, is a derivative of milk thistle given intravenously and used for mushroom poisoning, according to Olson. The drug is not available in the U.S., but UCSF doctors ordered an emergency supply for the three patients last week. Conclusive testing proving the drug's efficacy has not been done, Olson said.

"We are looking for a way to have it available in the future," he said. "We think it might be helpful, we don't know."

While Amanita phalloides can be deadly in very small amounts, the reaction can vary depending on who consumes the mushroom and where it was grown. The death caps grow throughout the Bay Area and are common around the base and near the roots of oak trees, Olson said.

The mushrooms are said to look, smell and taste wonderful and appear similar to different kinds of edible mushrooms, he said.

One person died in 2008 in the state from mushroom poisoning, Olson said. About six mushroom poisoning cases are reported each year in the Bay Area, with most of the cases from Amanita phalloides.

"Of those cases one of two will either die or have a liver transplant," he said.

Deadly mushrooms differ from the harmful mushrooms in the onset of sickness symptoms, according to Olson.

"The common ones usually cause symptoms within an hour or so of eating," he said. "Deadly mushrooms have a very characteristic delay in onset."

In the case of highly toxic mushrooms, symptoms can begin eight to 12 hours after consumption, he said. After a day or so of gastrointestinal upset that can cause extreme dehydration, the stomach symptoms subside and the liver becomes very damaged. Two or three days after eating a toxic mushroom, a patient can experience liver failure and the need for a liver transplant, Olson said.

Nonetheless, wild mushrooms are harvested by those who enjoy the hobby, those who sell the mushrooms to high-end restaurants or markets and those who research the fungi. Olson said harvesters should be informed and get into contact with a local mycological society, avoiding consumption unless helped by an expert.

Asked if he would pick and eat wild mushrooms, the poison control specialist said he does not have the palette for such a risk.

"I wouldn't do it," Olson said.