Ingestion of Amanita muscaria mushrooms results in transient central nervous system excitation and depression mediated
by its components, ibotenic acid and muscimol. The mushroom is distributed worldwide
and ingestions occur with some frequency. Although these ingestions have traditionally
been considered benign, serious complications can occur. We present 2 cases of serious
toxicity, including a fatality. The first case was a 44-y-old man who presented to
the emergency department (ED) after cardiopulmonary arrest approximately 10 h after
ingesting 4 to 5 dried A muscaria mushroom caps, which he used for their mind-altering effects. Despite successful
resuscitation, he remained unresponsive and hypotensive and died 9 days later. The
second case was a 75-y-old man who presented to the ED after accidentally consuming
one large A muscaria mushroom cap he foraged in Eastern Turkey. The patient initially presented to the
ED with hallucinations followed by lethargy, and he was intubated for airway protection.
The patient’s condition gradually improved, and he made a full recovery. A muscaria ingestion should not be considered benign as serious outcomes do occur. An understanding
of how the main neuroactive chemicals, ibotenic acid and muscimol, affect the brain
can help anticipate outcomes. Several high-risk features that portend a more serious
course are identified.
Keywords
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Article info
Publication history
Published online: October 06, 2022
Accepted:
June 19,
2022
Received:
March 18,
2022
Identification
Copyright
© 2022 Wilderness Medical Society. Published by Elsevier Inc.
