Treatment of A.philloides poisoning

brianmc at brianmc at
Fri Feb 14 13:26:35 EST 1997

In article <19970111003200.TAA29152 at>, mdavis9021 at wrote:

> Up until how much time after ingestion of A.philloides is activated
> charcoal treatment effective at preventing liver damage? Please provide
> references to medical articles or texts.

Denis Benjamin's book is clearly the most up to date, and would provide most of the medical references you desire:

Benjamin, Denis R. (1995) Mushrooms poisons and panaceas: a handbook for naturalists, mycologists, and physicians (W.H. Freeman and Co., New York)

ISBN 0-7167-2600-9

An older work, still considered definitive is Lincoff and Mitchel's "Toxic and Hallucinogenic Mushroom Poisoning"  It may be difficult to come by:

Lincoff, Gary & D.H. Mitchel (1977) Toxic and Hallucinogenic Mushroom Poisoning (Van Norstrand Reinhold)

Tom McCloud is essentially correct in that charcoal absorption is at best an early presymptomatic treatment, and most patients don't seek treatment until symptoms appear.  Benjamin cautions at length about the dangers of overtreatment, and once severe vomiting and diarrhea have begun it's important to begin symptomatic and supportive treatment as quickly as possible.

Basically, if the patient arrives within six hours of ingestion, and is either asymptomatic, or barely beginning to display signs of nausea, etc., decontamination of the gastrointestinal tract may still be worthwhile.

As an aside, A. phalloides is not the only mushroom that contains this poison, and physicians would do well to diagnose and treat upon the basis of the symptoms rather than wait for a precise identification of the mushroom. (This from one who is occasionally called upon to provide mushroom ID in poisoning cases).

--Brian McNett

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