Group in the POISINDEX classification: IV
Mushrooms producing:
(1) Inocybe species
(2) Clitocybe species
(3) Mycena para
(4) Omphalotus olearius
Toxin: L-muscarine
The toxin is heat stable.
Onset is usually within 15-60 minutes, but rarely may take up to 24 hours
Clinical features:
(1) marked sweating
(2) nausea and vomiting
(3) abdominal colic and cramps
(4) miosis with blurred vision
(5) lacrimation with a runny nose
(6) salivation
(7) diarrhea
(8) bradycardia
(9) bronchoconstriction with wheezing and shortness of breath
(10) warm and flushed skin
(11) fatalities are uncommon
Symptoms may last up to 24 hours after onset.
Initial treatment consists of emptying the stomach unless emesis has occurred.
Atopine is an effective treatment. The doses recommended by Lampe are:
(1) for children < 2 years of age: 0.2 mg
(2) for children 2-4 years of age: 0.3 mg
(3) for children 4-10 years of age: 0.4 mg
Blackman recommends intravenous atropine titrated to control excess secretions:
(1) children: 0.05 mg per kg in children
(2) adults: 0.5 to 1.0 mg
