[Mushroom poisoning--classification, symptoms and therapy]

The most serious poisonings are the hepatotoxic ones which are caused above all by Amanita phalloides, virosa, verna, Lepiota helveola, Galerina marginata, Gyromitra esculenta, Hypholoma fasciculare, and nephroptoxic intoxications which are caused above all by Cortinarius orrelanus and Paxillus involutus. Neurotoxic and psychotropic intoxications develop after ingestion of Inocybe, Clitocybe, Amanita-panterina, muscaria and Psilocybe. Most frequently the gastroenteric type of mushroom poisoning is encountered which is caused by many species e.g. Boletus satanas, Entoloma sinuatum and others. In the diagnosis anamnestic data are used, the clinical picture, mycological and toxicological examinations of residues of mushrooms, their spores and toxins. Therapeutic strategy comprises elimination methods gastric lavage, intestinal lavage and administration of large amounts of animal charcoal, forced diuresis, haemoperfusion, haemodialysis or peritoneal dialysis, administration of antidotes and symptomatic treatment, i.e. mainly rehydration and restoration of the mineral balance. Early and comprehensive treatment are important.