Tricholoma equestre (aka T. flavoviren) is a widely-distributed wild mushroom that may cause toxic rhabdomyolysis.
Distribution: worldwide
The mushroom has a yellowish cap and whitish stem ("yellow-knight fungus")
Toxin: uncertain (extractable by water and by chloroform-methanol)
Features of the toxin: since patients had eaten meals made with the mushroom, it is likely that the toxin is heat stable
Onset: 24 to 72 hours after last ingestion (some had eaten multiple meals)
Clinical features:
(1) fatigue
(2) facial erythema (flushing)
(3) muscle weakness
(4) myalgia
(5) muscle stiffness
(6) profuse sweating
(7) nausea without vomiting
(8) elevated serum CK
(9) dark urine (myoglobinuria)
(10) renal dysfunction with oliguria or anuria
(11) dyspnea
(12) acute myocarditis
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Specialty: Toxicology, Emergency Medicine, Critical Care
