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
- Carbamate toxicity
- Mushroom toxicity, especially:
- Organophosphate toxicity
- Nerve agent
- Sarin
- VX
- Novichok agent
- Nicotine toxicity (look alike)
- Acetylcholinesterase inhibitor overdose (e.g in myasthenia gravis or post anesthesia reversal)
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
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