Mushrooms: The Good, the Bad, and the Deadly

Mushrooms are widely consumed for their culinary and nutritional value; however, some species pose serious toxicological risks. While edible varieties such as Agaricus bisporus dominate global and US markets, others, including Amanita phalloides, contain potent amatoxins associated with high morbidity and mortality. Mushroom poisoning, or mycetism, occurs across diverse populations and commonly results from accidental ingestion or species misidentification. Diagnosis is often delayed due to difficulties in accurate identification, complicating timely management. This report aims to describe two cases of severe Amanita poisoning to illustrate the clinical presentation, diagnostic challenges, and management strategies, including supportive care, antidotal therapy, and consideration for liver transplantation. It also aims to highlight the public health impact of amatoxin-containing mushrooms and underscore the need for early recognition, culturally sensitive education, and effective preventive measures to reduce mushroom-related health risks.