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Fatal muscarinic syndrome after eating wild mushrooms

John L Pauli and Carole L Foot
Med J Aust 2005; 182 (6): 294-295.

Death from mushroom poisoning in Australia is rare and usually due to liver failure produced by Amanita phalloides. We report a 53-year-old woman in Queensland who died from an acute muscarinic syndrome 10 hours after eating mushrooms belonging to the genus Rubinoboletus. To our knowledge, this is the first death in Australia caused by non-amatoxin-producing mushrooms. It highlights the need for awareness of non-amatoxin-producing mushrooms as potentially lethal.

Reports of significant morbidity or mortality from mushroom ingestion in Australia have predominantly involved the “deathcap” mushroom (Amanita phalloides),1,2 which contains amatoxins that cause hepatic necrosis and often renal failure. Most of these reports have come from Victoria and the Australian Capital Territory.1,3 We report a death in Queensland after mushroom ingestion producing a severe muscarinic syndrome. The mushrooms involved were identified as Rubinoboletus sensu lato pro tempe, from the bolete group, which includes several species known to produce muscarine.

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  • John L Pauli1
  • Carole L Foot2

  • Princess Alexandra Hospital, Brisbane, QLD

Correspondence: jpauli@member.rcpa.edu.au

Acknowledgements: 

We thank Mr Nigel Fechner (Queensland Herbarium, Brisbane, QLD) for identifying and photographing the mushroom.

Competing interests:

None identified.

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  • 2. Benjamin DR. Amatoxin syndrome. Mushrooms: poisons and panaceas — a handbook for naturalists, mycologists and physicians. New York: WH Freeman and Company, 1995: 198-241.
  • 3. Nicholson FB, Korman MG. Death from Amanita poisoning. Aust N Z J Med 1997; 27: 448-449.
  • 4. Stallard D, Edes TE. Muscarinic poisoning from medications and mushrooms. Postgrad Med 1989; 85: 341-345.
  • 5. Chilton WS. The chemistry and node of action of mushroom toxins. In: Spoerke DG, Rumack BH, editors. Handbook of mushroom poisoning, 2nd ed. Boca Raton, Fla: CRC Press, 1994: 165-231.
  • 6. McPartland JM, Vilgalys RJ, Cubeta MA. Mushroom poisoning. Am Fam Physician 1997; 55: 1797-1804.
  • 7. Harris AR, Stokes JB. Amanita preissii “mushroom” poisoning. Med J Aust 1976; 2: 568-571.

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