Skip to main content
SpringerLink
Log in

Investigation and analysis of 102 mushroom poisoning cases in Southern China from 1994 to 2012

  • Published:
Fungal Diversity Aims and scope Submit manuscript

Abstract

Mushroom poisoning is the main cause of mortality in food poisoning incidents in China. Although some responsible mushroom species have been identified, some were identified inaccuratly. This study investigated and analyzed 102 mushroom poisoning cases in southern China from 1994 to 2012, which involved 852 patients and 183 deaths, with an overall mortality of 21.48 %. The results showed that 85.3 % of poisoning cases occurred from June to September, and involved 16 species of poisonous mushroom: Amanita species (A. fuliginea, A. exitialis, A. subjunquillea var. alba, A. cf. pseudoporphyria, A. kotohiraensis, A. neoovoidea, A. gymnopus), Galerina sulciceps, Psilocybe samuiensis, Russula subnigricans, R. senecis, R. japonica, Chlorophyllum molybdites, Paxillus involutus, Leucocoprinus cepaestipes and Pulveroboletus ravenelii. Six species (A. subjunquillea var. alba, A. cf. pseudoporphyria, A. gymnopus, R. japonica, Psilocybe samuiensis and Paxillus involutus) are reported for the first time in poisoning reports from China. Psilocybe samuiensis is a newly recorded species in China. The genus Amanita was responsible for 70.49 % of fatalities; the main lethal species were A. fuliginea and A. exitialis. Russula subnigricans caused 24.59 % of fatalities, and five species showed mortality >20 % (A. fuliginea, A. exitialis, A. subjunquillea var. alba, R. subnigricans and Paxillus involutus). Mushroom poisoning symptoms were classified from among the reported clinical symptoms. Seven types of mushroom poisoning symptoms were identified for clinical diagnosis and treatment in China, including gastroenteritis, acute liver failure, acute renal failure, psychoneurological disorder, hemolysis, rhabdomyolysis and photosensitive dermatitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Benjamin DR (1995) Mushrooms: poisons and panaceas, a handbook for naturalists, mycologists and physicians. W. H. Freeman and Company, New York

    Google Scholar 

  • Berger KJ, Guss DA (2005a) Mycotoxins revisited: Paret I. J Emerg Med 28:53–62

    Article  PubMed  Google Scholar 

  • Berger KJ, Guss DA (2005b) Mycotoxins revisited: Paret II. J Emerg Med 28:175–183

    Article  PubMed  Google Scholar 

  • Boedijn KB (1938) A poisonous species of the genus Phaeomarasmius (Agaricaceae). Bull Jard Bot Buitenzorg Ser III 16:78–82

    Google Scholar 

  • Bresinsky A, Besl H (1990) A colour atlas of poisonous fungi: a handbook for pharmacists, doctors and biologists. Wolfe Publishing Ltd, London

    Google Scholar 

  • Cao RM, Liu Z, Zhang J, Liu SQ, Sun YB, Zhang J, Liu SH, Liu LZ, Cao XL, Jia TH (2011) Disposal report of a case of mushroom poisoning caused by Amanita pallidorosea (in Chinese). J Shangdong Univ Health Sci 49:160–164

    CAS  Google Scholar 

  • Chen JL, Zhang SX, Chen BZ, Zhang HY (1987) Investigation report of poisoning caused by Inocybe asterospora (in Chinese). Jundui weisheng Zazhi 5:36–38

    Google Scholar 

  • Chen XJ, Su ZY, Yang ZP, Pan BR (1991) Clinical analysis of 137 cases of acute poisonous mushroom poisoning (in Chinese). Mod Diagn Treat 2:398–400

    Google Scholar 

  • Chen ZH, Hu JS, Zhang ZG, Zhang P, Li DP (2003) Determination and analysis of the main amatoxins and phallotoxins in 28 species of Amanita from China (in Chinese). Mycosystema 22:565–573

    CAS  Google Scholar 

  • Christine KS, Hans P (2003) Cytotoxic fungi—an overview. Toxicon 42:339–349

    Article  Google Scholar 

  • Deng WQ, Li TH, Xi PG, Gan LX, Xiao ZD, Jiang ZD (2011) Peptide toxin components of Amanita exitialis basidiocarps. Mycologia 103:946–949

    Article  CAS  PubMed  Google Scholar 

  • Diaz JH (2005) Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med 33:427–436

    Article  PubMed  Google Scholar 

  • Ellenhorn MJ, Barceloux DG (1988) Medical toxicology, diagnosis and treatment of human poisoning. Elsevier, New York

    Google Scholar 

  • Enjalbert F, Rapior S, Nouguier-Soule J, Guillon S, Amoroux N, Cabot C (2002) Treatment of amatoxin poisoning: 20-year retrospective analysis. J Toxicol Clin Toxicol 40:715–757

    Article  CAS  PubMed  Google Scholar 

  • Flammer R (1985) Paxillus syndrome: immunohemolysis following repeated mushroom ingestion. Schweiz Rundsch Med Prax 74:997–999

    CAS  PubMed  Google Scholar 

  • Guzmán G, Bandala VM, Allen JW (1993) A new bluing Psilocybe from Thailand. Mycotaxon 46:155–160

    Google Scholar 

  • Habtemariam S (1996) Cytotoxicity of extracts from the mushroom Paxillius involutus. Toxicon 34:711–713

    Article  CAS  PubMed  Google Scholar 

  • Hatanaka S (1992) Amino acids from mushrooms. Prog Chem Org Nat Prod 59:1–139

    CAS  Google Scholar 

  • Hatanaka S, Kawakami K (1980) Isolation and identification of L-2-amino-4,5-hexadienoic acid from Amanita neoovoidea. Sci Pap Coll Gen Ed Univ Tokyo 30:147–150

    CAS  Google Scholar 

  • Hatanaka S, Niimura Y, Takishima K, Sugiyama J (1998) (2R)-2-amino-6-hydroxy-4-hexynoic acid, and related amino acids in the fruiting bodies of Amanita miculifera. Phytochemistry 49:573–578

    Article  CAS  Google Scholar 

  • He JY, Ma L (2001) Investigation and treatment of four cases of mushroom poisoning in Guangzhou (in Chinese). Chin J Food Hyg 13:29–31

    CAS  Google Scholar 

  • Hu JS, Zhang P, Zeng J, Chen ZH (2012) Determination of amatoxins in different tissues and development stages of Amanita exitialis. J Sci Food Agric 92:2664–2667

    Article  CAS  PubMed  Google Scholar 

  • Huang L, Lei ZW, Cao CS (2002) The first poisoning case caused by Amanita fuliginea in Province Jiangxi (in Chinese). Acta Acad Medic Jiangxi 42:123–124

    Google Scholar 

  • Imazeki R, Hongo T (1989) Colored illustrations of mushrooms of Japan. Hoikusha Press, Osaka

    Google Scholar 

  • Iwafuchi Y, Morita T, Kobayashi H, Kasuga K, Ito K, Nakagawa O, Kunisada K, Miyazaki S, Kamimura A (2003) Delayed onset acute renal failure associated with Amanita pseudoporphyria Hongo ingestion. Intern Med 42:78–81

    Article  PubMed  Google Scholar 

  • Jin LM, Li Q (2009) Analysis of food poisoning events in China from 2004 to 2007 (in Chinese). Dis Surveill 24:459–461

    Google Scholar 

  • Kirchmair M, Carrilho P, Pfab R, Haberl B, Felgueiras J, Carvalho F, Cardoso J, Melo I, Vinhas J, Neuhauser S (2012) Amanita poisonings resulting in acute, reversible renal failure: new cases, new toxic Amanita mushrooms. Nephrol Dial Transplant 27:1380–1386

    Article  CAS  PubMed  Google Scholar 

  • Koppel C (1993) Clinical symptomatology and management of mushroom poisoning. Toxicon 31:1513–1540

    Article  CAS  PubMed  Google Scholar 

  • Li XQ, Zhou X, Shi J, Liu WW, Ling HX, Jiang CQ, Huang RH (2002) Blood purification treatment of Amanita phalloides induced multiple-organ dysfunction syndrome (in Chinese). Chin J Blood Purif 1:17–19

    CAS  Google Scholar 

  • Li SH, Zhao YC, Yu FQ, Wang XH, Zhang XL, Liu PG (2011) Systematics of the easily confusing poisonous Boletes from Yunnan wild mushroom markets (in Chinese). Edible Fungi of China 30:34–36

    Google Scholar 

  • Liu PG, Yang ZY (1992) Cordierites frondosa – a poisonous mushroom easily confused with Auricularia auricular (in Chinese). Edible Fungi of China 11:27

    CAS  Google Scholar 

  • Mao XL (1987) Identification to poisonous mushrooms (in Chinese). Popular Science Press, Beijing

    Google Scholar 

  • Mao XL (2000) The Macrofungi in China (in Chinese). Henan Science and Technology Press, Zhengzhou

    Google Scholar 

  • Mao XL (2006) Poisonous mushrooms and their toxins in China (in Chinese). Mycosystema 25:345–363

    CAS  Google Scholar 

  • Matsuura M, Sailawa Y, Inui K, Nakae K, Igarashi M, Hashimoto K, Nakata M (2009) Identification of the toxic trigger in mushroom poisoning. Nat Chem Biol 5:465–467

    Article  CAS  PubMed  Google Scholar 

  • Mengs U, Pohl RT, Mitchell T (2012) Legalon® SIL: the antidote of choice in patients with acute hepatotoxicity from amatoxin poisoning. Curr Pharm Biotechnol 13:1964–1970

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Mycologist Group of Institute of Microbiology of Chinese Academy of Sciences (1975) Poisonous mushrooms (in Chinese). Science Press, Beijing

    Google Scholar 

  • Nguyen VT, Giannoni F, Dubois MF, Seo SJ, Vigeneron M, Kédinger C, Bensaude O (1996) In vivo degradation of RNA polymerase II largest subunit triggered by alpha amanitin. Nucleic Acids Res 24:2924–2929

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Niu JF, Tu WX, Ni DX (2011) Public health emergencies of mushroom poisoning in China, 2004–2009 (in Chinese). Dis Surveill 26:231–233

    Google Scholar 

  • Ren CS, Wang WQ, Xu ZH, Lu HH, Gao QJ, Guo ZJ, Yuan FH, Yang HB, Qian GS (2007) A study of the clinical classification of 3638 cases of mushroom poisoning (in Chinese). Chin J Intern Med 46:229–232

    Google Scholar 

  • Rudd M, Luse D (1996) Amanitin greatly reduces the rate of transcription by RNA polymerase II ternary complexes but fails to inhibit some transcript cleavage modes. J Biol Chem 271:21549–21558

    Article  CAS  PubMed  Google Scholar 

  • Saviuc P, Danel V (2006) New syndromes in mushroom poisoning. Toxicol Rev 25:199–209

    Article  CAS  PubMed  Google Scholar 

  • Sheng YP (1981) Investigation of 27 mushroom poisoning cases (in Chinese). Beijing Med J 3:49

    Google Scholar 

  • Shi GQ, Huang WL, Zhang J, Zhao H, Shen T, Fontaine RE, Yang L, Zhao S, Lu BL, Wang YB, Ma L, Li ZX, Gao Y, Yang ZL, Zeng G (2012) Clusters of sudden unexplained death associated with the mushroom, Trogia venenata, in rural Yunnan Province, China. PLoS One 7(5):e35894. doi:10.1371/journal.pone. 0035894

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Spoerke DG, Rumack BH (1994) Handbook of mushroom poisoning: diagnosis and treatment. CRC Press, London

    Google Scholar 

  • Sun YJ, Yuan W, Liu LG, Zhang LJ, Shi GQ, Wang QX (2012) An outbreak of gastroenteritis caused by poisonous Boletus mushroom in Sichuan, China, 2012 (in Chinese). Chin J Epidemiol 33:1261–1264

    Google Scholar 

  • Takahashi A, Agatsuma T, Matsuda M, Ohta T, Nunozawa T, Endo T, Nozoe S (1992) Russuphellin A, a New Cytotoxic Substances from the Mushroom Russula subnigricans Hongo. Chem Pharm Bull 40:3185–3188

    Article  CAS  PubMed  Google Scholar 

  • Takahashi A, Agatsuma T, Ohta T, Nunozawa T, Endo T, Nozoe S (1993) Russuphellins B, C, D, E and F, New Cytotoxic Substances from the Mushroom Russula subnigricans Hongo. Chem Pharm Bull 41:1726–1729

    Article  CAS  PubMed  Google Scholar 

  • Warden CR, Benjamin DR (1998) Acute renal failure associated with suspected Amanita smithiana mushroom ingestions: a case series. Acad Emerg Med 5:808–812

    Article  CAS  PubMed  Google Scholar 

  • Weng XB, Ji YG, Zhou CP, Zhang GR, Zhong JR, Dou QP (1991) Investigation on two new poisoning funguses causing food poisoning in Guizhou Province (in Chinese). J Guizhou Nor Univ Nat Sci 9:5–9

    Google Scholar 

  • Wieland T (1986) Peptides of poisonous Amanita mushrooms. Springer, New York

    Book  Google Scholar 

  • Winkelmann M, Stangel W, Schedel I, Grabensee B (1986) Severe hemolysis caused by antibodies against the mushroom Paxillus involutus and its therapy by plasma exchange. Klin Wschr 64:935–938

    Article  CAS  PubMed  Google Scholar 

  • Yamaura Y (2013) Recent trends of mushroom poisoning in Japan. Jpn J Toxicol 26:39–43

    Google Scholar 

  • Yamaura Y, Fukuhara M, Takabatake E, Ito N, Hashimoto T (1986) Hepatotoxic action of a poisonous mushroom, Amanita abrupta in mice and its toxic component. Toxicology 38:161–173

    Article  CAS  PubMed  Google Scholar 

  • Yang ZL (1997) Die Amanita-Arten von Suedwestchina. Biblioth Mycol 170:1–240

    Google Scholar 

  • Yang ZL (2000a) Species diversity of the genus Amanita (Basidiomycetes) in China. Acta Bot Yunnanica 22:135–142

    Google Scholar 

  • Yang ZL (2000b) Revision of the Chinese Amanita collections deposited in BPI and CUP. Mycotaxon 75:117–130

    Google Scholar 

  • Yang ZL (2005) Flora Fungorum Sinicorum vol. 27, Amaniataceae. Science Press, Beijing

    Google Scholar 

  • Yang ZL, Zhang LF (2002) Revision of collections of Amantia (Agaricales) from Hunan Province, Central China. Acta Botanica Yunnanica 24(6):715–722

    Google Scholar 

  • Yang ZL, Li YC, Tang LP, Shi GQ, Zeng G (2012) Trogia venenata (Agaricales), a novel poisonous species caused hundreds of deaths in southwestern China. Mycol Prog 11:937–945

    Article  Google Scholar 

  • Yu SY, Wang XW, Zhao J, Liu H, Hu TF, Wan QQ, Li JJ, Wang R (2012) Epidemiological analysis on the food poisoning originated from wild mushroom in Yunnan Province in 2004–2010. Chin J Food Hygiene 24:71–73

    Google Scholar 

  • Zhang ZG, Liu JQ, Chen ZH, Zhang P, Li DP, Cao FX, Zhou SR (2002) The investigation of 36 accidents by poisonous mushroom in Hunan (in Chinese). Mod Prev Med 29:301–305

    Google Scholar 

  • Zhang LF, Yang JB, Yang ZL (2004) Molecular phylogeny of eastern Asian species of Amanita (Agaricales, Basidiomycota): taxonomic and biogeographic implications. Fungal Divers 17:219–238

    Google Scholar 

  • Zhang P, Chen ZH, Xiao B, Tolgor B, Bao HY, Yang ZL (2010) Lethal amanitas of East Asia characterized by morphological and molecular data. Fungal Divers 42:119–133

    Article  Google Scholar 

  • Zhou WN, Zhang DZ (2005) Mushrooms of Taiwan. Yuan-Liou Publishing Co Ltd, Taibei

    Google Scholar 

  • Zhou GS, Lin DX, Huang KY, He WX, Yin ZF, Yuan XY, Liang Q (2009) Investigation and analysis of mushroom poisoning cases in Hezhou, Guangxi from 1982 to 2008 (in Chinese). Applied Prev Med 15:226–227

    Google Scholar 

  • Zhou ZY, Shi GQ, Fontaine R, Wei K, Feng T, Wang F, Wang GQ, Qu Y, Li ZH, Dong ZJ, Zhu HJ, Yang ZL, Zeng G, Liu JK (2012) Evidence for the natural toxins from the mushroom Trogia venenata as a cause of sudden unexpected death in Yunnan Province, China. Angew Chem Int Ed Engl 51:2368–2370

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge Prof. Dr. D. P. Li, Dr. F. Fang, Dr. J. S. Hu, J. Q. Liu, S. Y. Jiang, Q. F. Gong, B. Y. Wei, Z. W. Zhang, S. H. Wu and other graduate students (College of Life Sciences, Hunan Normal University) for participating in the investigation of mushroom poisoning incidents. Prof. Dr. Z. L. Yang (Kunming Institute of Botany, Chinese Academy of Sciences) is acknowledged for the identification of some Amanita species, reviewing the manuscript and providing valuable suggestions. Prof. Dr. T. H. Li (Guangdong Institute of Microbiology) is acknowledged for the collection of A. exitialis. We thank Prof. Dr. G. L. Xiao (Xiangya Hospital of Central South University) and many people in the CDC and hospitals in southern China for offering data on mushroom poisoning and clinical symptoms. This study was supported by the National Science Foundation of China (No. 30972073, 30871766, 30471208 and 30070005).

Author information

Authors and Affiliations

  1. College of Life Sciences, Hunan Normal University, Changsha, 410081, China

    Zuohong Chen, Ping Zhang & Zhiguang Zhang

Authors
  1. Zuohong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ping Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhiguang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zuohong Chen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chen, Z., Zhang, P. & Zhang, Z. Investigation and analysis of 102 mushroom poisoning cases in Southern China from 1994 to 2012. Fungal Diversity 64, 123–131 (2014). https://doi.org/10.1007/s13225-013-0260-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13225-013-0260-7

Keywords

Search

Navigation