Liver injury related to deathcap (amanita) mushrooms
Death cap (amanita phalloides) is a gilled mushroom and looks similar to other edible mushrooms. However, they are one of the most dangerous species of mushrooms and are responsible for around 90% of fatal mushroom poisonings. Even if only a small piece of a death cap mushroom is accidentally ingested, it can be fatal without prompt treatment.
The course of death cap poisoning occurs in three phases:
- Latency period: symptomless, lasts between 6-15h or rarely up to 24h after mushroom consumption.
- Gastrointestinal phase: 6-15h or rarely up to 24h after mushroom consumption. This causes vomiting and heavy diarrhoea containing blood, leading to dehydration and electrolye imbalance.
- Hepatorenal phase: 24-48h after mushroom consumption symptoms initially appear to improve, however at the same time transaminases rise sharply and acute liver failure with hepatic encephalopathy (confusion to coma) and renal failure develops.
Mushrooms from the supermarket are safe to eat, but mushrooms you have picked yourself mean there is a risk of confusing poisonous mushrooms with edible varieties. If you pick mushrooms, you should be well-educated in the differences, but in case of doubt you can also take your pickings to an official mushroom inspection office (www.vapko.ch).
The 24h emergency number for poisonings in Switzerland is 145 (Tox Info Suisse). If mild symptoms occur after consuming mushrooms, ring Tox Info Suisse directly for advice. In the event of severe symptoms, calling an ambulance (144) is recommended.
If some mushrooms are leftover, it is useful to keep these for examination. Samples of vomit can also help to identify the mushrooms.
Treatment in the hospital is usually carried out in the intensive care unit, where an antidote is also administered intravenously without delay. Depending on how much time has passed since the poisoning, a liver transplant can be necessary in life-threatening cases.