CA Mushrooms

Toxic Fungi of Western North America

by Thomas J. Duffy, MD

Getting Started

For cases in which Amanita phalloides or other deadly amatoxic fungi are suspected, go at once to the section titled Guide to the identification of mushroom poisoning by symptoms and, if appropriate, The amatoxic group. For a thumbnail guide to the treatment of amatoxins, go to the end of the discussion on amatoxins to Outline and summary of treatment for poisoning by amatoxins.

To read this paper, start with the Table of Contents, below. To navigate you may use the Previous Page — Contents — References — Glossary — Next Page menu that is at the bottom of each page. Within the text, linked mushroom names go to a description and photographs of the mushroom at The Fungi of California. These will open in a new browser window.

If you click on the in-line photographs, you will usually be taken to a MUCH larger version of the photograph. When viewing the larger image, hit escape or 'x' to take you back to the page you were reading. Clicking on the end-note numbers [e.g. (45), (206)] will take you to the appropriate section of the References page.

The Toxic Fungi of Western North America is also available as a PDF file (8 MB).


    Introductory Material

  1. Dedication, Preface, & Acknowledgements
  2. An Introduction to Mushrooms & Mushroom Poisoning

  3. Introduction and collection of specimens
  4. General overview of mushroom poisonings
  5. Ecology and general anatomy of fungi
  6. Description and habitat of Amanita phalloides and Amanita ocreata
  7. History of Amanita ocreata and Amanita phalloides in the West
  8. The classical history of Amanita phalloides and related species
  9. Mushroom poisoning case registry
  10. “Look-Alike” mushrooms
  11. Identification aids
  12. Guidelines for pot-hunters
  13. Insecticides and other toxic sprays
  14. Guide to the identification of mushroom poisoning by symptoms
  15. Group I toxins: Amatoxins

  16. The amatoxic group
  17. Ethnicity and amanitin poisoning
  18. Toxins of Amanita phalloides, other amatoxic Amanita and amatoxic species in the genera Lepiota, Galerina and Conocybe
  19. The Wieland-Meixner qualitative test for amatoxins
  20. The pathologic picture of amanitins
  21. Pregnancy and amanitin poisoning
  22. Fatality rates from selected studies published since 1970
  23. Evaluation of amanitin treatment
  24. Prognostic indicators for likely fatality
  25. The clinical course of amanitin poisoning
  26. Detailed treatment of amanitin poisoning
  27. Outline and summary of treatment for poisoning by amatoxins
  28. Group II toxins: Ibotenic Acid/Muscimol

  29. Isoxazole poisoning from Amanita muscaria & Amanita pantherina (pantherine syndrome)
  30. Toxins of the ibotenic acid/muscimol group (pantherine poisoning)
  31. Symptoms of ibotenic/muscimol poisoning (isoxazol poisoning)
  32. Treatment of ibotenic acid/muscimole poisoning
  33. Group III toxins: Amanita smithiana

  34. Amanita smithiana poisoning & unclassified renal/hepatic toxicity
  35. Clinical picture, presumed toxin and treatment
  36. Group IV toxins: Orellanine

  37. Delayed renal failure with Cortinarius species
  38. The genus Cortinarius in general
  39. Toxins of Cortinarius orellanus
  40. Clinical course and treatment
  41. Group V toxins: Gyromitrin

  42. Gyromitrin group
  43. Gyromitrin toxins
  44. The clinical picture of gyromitrin poisoning
  45. Treatment of gyromitrin toxicity
  46. Group VI toxins: Paxillus involutus

  47. Autoimmune hemolysis with Paxillus involutus
  48. Group VII toxins: Muscarine

  49. The muscarine group toxins
  50. General description and occurrence
  51. The clinical picture of muscarine poisoning
  52. Treatment of muscarine poisoning
  53. Group VIII toxins: Hallucinogenic indoles (psilocybin)

  54. The "New World" history of psilocybin containing mushrooms
  55. Taxonomic and legal problems
  56. General description and occurrence
  57. Psilocybin and psilocin toxins
  58. The clinical picture of psilocybin toxicity
  59. Treatment of psilocybin toxicity
  60. Group IX toxins: Coprine

  61. Disulfiram-like reactions to alcohol
  62. Group X toxins: Gastrointestinal irritants, toxins and idiosyncrasies

  63. GI reactions due to fungi usually considered edible
  64. Mushrooms known for their GI toxins or irritants
  65. Group XI toxins: Miscellaena

  66. Miscellaneous toxins
  67. Addendums, Glossary, & References

  68. Addendum 1: Scientific names and the conventions used in the text
  69. Addendum 2: Fungal nomenclature, fungal taxonomy, and effect on fungal names
  70. Glossary
  71. References