Fungal Diversity

, Volume 64, Issue 1, pp 123–131 | Cite as

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

  • Zuohong Chen
  • Ping Zhang
  • Zhiguang Zhang


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.


Mushroom poisoning Amanita Syndrome Psilocybe samuiensis Rhabdomyolysis 



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).


  1. Benjamin DR (1995) Mushrooms: poisons and panaceas, a handbook for naturalists, mycologists and physicians. W. H. Freeman and Company, New YorkGoogle Scholar
  2. Berger KJ, Guss DA (2005a) Mycotoxins revisited: Paret I. J Emerg Med 28:53–62PubMedCrossRefGoogle Scholar
  3. Berger KJ, Guss DA (2005b) Mycotoxins revisited: Paret II. J Emerg Med 28:175–183PubMedCrossRefGoogle Scholar
  4. Boedijn KB (1938) A poisonous species of the genus Phaeomarasmius (Agaricaceae). Bull Jard Bot Buitenzorg Ser III 16:78–82Google Scholar
  5. Bresinsky A, Besl H (1990) A colour atlas of poisonous fungi: a handbook for pharmacists, doctors and biologists. Wolfe Publishing Ltd, LondonGoogle Scholar
  6. 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 49:160–164Google Scholar
  7. Chen JL, Zhang SX, Chen BZ, Zhang HY (1987) Investigation report of poisoning caused by Inocybe asterospora (in Chinese). Jundui weisheng Zazhi 5:36–38Google Scholar
  8. Chen XJ, Su ZY, Yang ZP, Pan BR (1991) Clinical analysis of 137 cases of acute poisonous mushroom poisoning (in Chinese). Mod Diagn Treat 2:398–400Google Scholar
  9. 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 22:565–573Google Scholar
  10. Christine KS, Hans P (2003) Cytotoxic fungi—an overview. Toxicon 42:339–349CrossRefGoogle Scholar
  11. Deng WQ, Li TH, Xi PG, Gan LX, Xiao ZD, Jiang ZD (2011) Peptide toxin components of Amanita exitialis basidiocarps. Mycologia 103:946–949PubMedCrossRefGoogle Scholar
  12. Diaz JH (2005) Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med 33:427–436PubMedCrossRefGoogle Scholar
  13. Ellenhorn MJ, Barceloux DG (1988) Medical toxicology, diagnosis and treatment of human poisoning. Elsevier, New YorkGoogle Scholar
  14. 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 40:715–757PubMedCrossRefGoogle Scholar
  15. Flammer R (1985) Paxillus syndrome: immunohemolysis following repeated mushroom ingestion. Schweiz Rundsch Med Prax 74:997–999PubMedGoogle Scholar
  16. Guzmán G, Bandala VM, Allen JW (1993) A new bluing Psilocybe from Thailand. Mycotaxon 46:155–160Google Scholar
  17. Habtemariam S (1996) Cytotoxicity of extracts from the mushroom Paxillius involutus. Toxicon 34:711–713PubMedCrossRefGoogle Scholar
  18. Hatanaka S (1992) Amino acids from mushrooms. Prog Chem Org Nat Prod 59:1–139Google Scholar
  19. 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 30:147–150Google Scholar
  20. 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 49:573–578CrossRefGoogle Scholar
  21. He JY, Ma L (2001) Investigation and treatment of four cases of mushroom poisoning in Guangzhou (in Chinese). Chin J Food Hyg 13:29–31Google Scholar
  22. 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 92:2664–2667PubMedCrossRefGoogle Scholar
  23. Huang L, Lei ZW, Cao CS (2002) The first poisoning case caused by Amanita fuliginea in Province Jiangxi (in Chinese). Acta Acad Medic Jiangxi 42:123–124Google Scholar
  24. Imazeki R, Hongo T (1989) Colored illustrations of mushrooms of Japan. Hoikusha Press, OsakaGoogle Scholar
  25. 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 42:78–81PubMedCrossRefGoogle Scholar
  26. Jin LM, Li Q (2009) Analysis of food poisoning events in China from 2004 to 2007 (in Chinese). Dis Surveill 24:459–461Google Scholar
  27. 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 27:1380–1386PubMedCrossRefGoogle Scholar
  28. Koppel C (1993) Clinical symptomatology and management of mushroom poisoning. Toxicon 31:1513–1540PubMedCrossRefGoogle Scholar
  29. 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 1:17–19Google Scholar
  30. 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 30:34–36Google Scholar
  31. Liu PG, Yang ZY (1992) Cordierites frondosa – a poisonous mushroom easily confused with Auricularia auricular (in Chinese). Edible Fungi of China 11:27Google Scholar
  32. Mao XL (1987) Identification to poisonous mushrooms (in Chinese). Popular Science Press, BeijingGoogle Scholar
  33. Mao XL (2000) The Macrofungi in China (in Chinese). Henan Science and Technology Press, ZhengzhouGoogle Scholar
  34. Mao XL (2006) Poisonous mushrooms and their toxins in China (in Chinese). Mycosystema 25:345–363Google Scholar
  35. 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 5:465–467PubMedCrossRefGoogle Scholar
  36. Mengs U, Pohl RT, Mitchell T (2012) Legalon® SIL: the antidote of choice in patients with acute hepatotoxicity from amatoxin poisoning. Curr Pharm Biotechnol 13:1964–1970PubMedCentralPubMedCrossRefGoogle Scholar
  37. Mycologist Group of Institute of Microbiology of Chinese Academy of Sciences (1975) Poisonous mushrooms (in Chinese). Science Press, BeijingGoogle Scholar
  38. 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 24:2924–2929PubMedCentralPubMedCrossRefGoogle Scholar
  39. Niu JF, Tu WX, Ni DX (2011) Public health emergencies of mushroom poisoning in China, 2004–2009 (in Chinese). Dis Surveill 26:231–233Google Scholar
  40. 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 46:229–232Google Scholar
  41. 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 271:21549–21558PubMedCrossRefGoogle Scholar
  42. Saviuc P, Danel V (2006) New syndromes in mushroom poisoning. Toxicol Rev 25:199–209PubMedCrossRefGoogle Scholar
  43. Sheng YP (1981) Investigation of 27 mushroom poisoning cases (in Chinese). Beijing Med J 3:49Google Scholar
  44. 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 PubMedCentralPubMedCrossRefGoogle Scholar
  45. Spoerke DG, Rumack BH (1994) Handbook of mushroom poisoning: diagnosis and treatment. CRC Press, LondonGoogle Scholar
  46. 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 33:1261–1264Google Scholar
  47. 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 40:3185–3188PubMedCrossRefGoogle Scholar
  48. 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 41:1726–1729PubMedCrossRefGoogle Scholar
  49. Warden CR, Benjamin DR (1998) Acute renal failure associated with suspected Amanita smithiana mushroom ingestions: a case series. Acad Emerg Med 5:808–812PubMedCrossRefGoogle Scholar
  50. 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 9:5–9Google Scholar
  51. Wieland T (1986) Peptides of poisonous Amanita mushrooms. Springer, New YorkCrossRefGoogle Scholar
  52. 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 64:935–938PubMedCrossRefGoogle Scholar
  53. Yamaura Y (2013) Recent trends of mushroom poisoning in Japan. Jpn J Toxicol 26:39–43Google Scholar
  54. 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 38:161–173PubMedCrossRefGoogle Scholar
  55. Yang ZL (1997) Die Amanita-Arten von Suedwestchina. Biblioth Mycol 170:1–240Google Scholar
  56. Yang ZL (2000a) Species diversity of the genus Amanita (Basidiomycetes) in China. Acta Bot Yunnanica 22:135–142Google Scholar
  57. Yang ZL (2000b) Revision of the Chinese Amanita collections deposited in BPI and CUP. Mycotaxon 75:117–130Google Scholar
  58. Yang ZL (2005) Flora Fungorum Sinicorum vol. 27, Amaniataceae. Science Press, BeijingGoogle Scholar
  59. Yang ZL, Zhang LF (2002) Revision of collections of Amantia (Agaricales) from Hunan Province, Central China. Acta Botanica Yunnanica 24(6):715–722Google Scholar
  60. 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 11:937–945CrossRefGoogle Scholar
  61. 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 24:71–73Google Scholar
  62. 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 29:301–305Google Scholar
  63. Zhang LF, Yang JB, Yang ZL (2004) Molecular phylogeny of eastern Asian species of Amanita (Agaricales, Basidiomycota): taxonomic and biogeographic implications. Fungal Divers 17:219–238Google Scholar
  64. 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 42:119–133CrossRefGoogle Scholar
  65. Zhou WN, Zhang DZ (2005) Mushrooms of Taiwan. Yuan-Liou Publishing Co Ltd, TaibeiGoogle Scholar
  66. 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 15:226–227Google Scholar
  67. 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 51:2368–2370PubMedCrossRefGoogle Scholar

Copyright information

© Mushroom Research Foundation 2013

Authors and Affiliations

  1. 1.College of Life SciencesHunan Normal UniversityChangshaChina

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