Crotinarius mushrooms

Overview

  • Contain toxin Orellanine
  • Cortinarius rainierensis in America
  • C. orellanus or C. speciosissimus in Europe

Clinical Features

  • Headache, chills, malaise, nausea and vomiting over days
  • Can see delayed renal failure 1-3 weeks after exposure

Differential Diagnosis

Mushroom toxicity by Type

Mushroom Toxin Pathologic Effect
AmanitaAmatoxinHepatotoxicity
CoprineDisulfiram-like
CrotinariusOrellanineDelayed renal failure
GyromitraGyromitrinSeizures
Ibotenic AcidAnticholinergic
MuscarineCholinergic
OrellaninNephrotoxicity
PsilocybinHallucinations

Evaluation

Workup

  • Urinalysis with microscopy
  • Urine electrolytes
  • Urine eosinophils

Management

  • Supportive
  • If renal failure from mushroom exposure, recovery can take several weeks
  • May need temporary hemodialysis

See Also

References

  • Diaz JH. Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med. 2005 Feb. 33(2):427-36.
  • Karlson-Stiber C, Persson H: Cytotoxic fungi—An overview. Toxicon 2003; 42:339–349.
  • Danel VC, Saviuc PF, Garon D: Main features of Cortinarius spp. poisoning: A literature review. Toxicon 2001; 39:1053–1060.
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