Clitocybe

Background

Clitocybe rivulosa
  • Genus of mushroom, many species of which contain muscarine, a toxin that induces cholinergic symptoms, with some species (e.g. Clitocybe dealbata and Clitocybe rivulosa, the "fool's funnel" or "false champignon") known to cause potentially fatal poisonings

Clinical Features

  • Symptoms usually start within 0.5-2hrs and resolve within 12hrs[1]
  • SLUDGE(M) syndrome (hyperperistalsis)
    • Salivation, Lacrimation, Urination, Diarrhea, GI pain, Emesis, Miosis
  • Bradycardia
  • Miosis
  • Bronchorrhea / Bronchospasm
  • Sweating
  • Vasodilation

Differential Diagnosis

Mushroom toxicity by Type

Mushroom Toxin Pathologic Effect
Amanita Amatoxin Hepatotoxicity
Coprine Disulfiram-like
Crotinarius Orellanine Delayed renal failure
Gyromitra Gyromitrin Seizures
Ibotenic Acid Anticholinergic
Muscarine Cholinergic
Orellanin Nephrotoxicity
Psilocybin Hallucinations

SLUDGE Syndrome

Evaluation

  • Clinical diagnosis
  • Evaluation to assess for alternative diagnoses

Management

  • Atropine for muscarinic symptoms
  • Supportive care, including careful airway monitoring/management

Disposition

See Also

External Links

References

Authors:

Claire