Pediatric emergency medicine trisk 3133 3133

Sensitive plant
Spider plant
Swedish ivy
Umbrella
Violets
Wandering jew
Weeping fig
Weeping willow
Wild onion
Zebra plant

Mushrooms
Mushrooms cause an estimated 50% of all deaths from plant and fungi poisoning
in the United States. The difficulty in accurate identification of mushrooms makes
reliance on such identification for appropriate management of ingestions
inappropriate to guide ED care.
Two main groups of mushrooms can be characterized on the basis of the time
interval between ingestion and symptom onset: those with the immediate onset of
symptoms and those with delayed onset. Regardless of the mushroom, the initial
management for all suspected poisonings includes consideration of activated
charcoal and other GI decontamination strategies.
Onset of symptoms within 6 hours of ingestion usually confers a benign
prognosis with careful attention to fluid and electrolyte management. Most
mushrooms have GI effects. There are several general classes of mushrooms in
this group, each possessing a unique toxicologic feature. Some “early-onset”
mushrooms cause muscarinic effects, usually within 15 minutes, such as
sweating, salivation, colic, and pulmonary edema. This syndrome responds to
atropine therapy. Other early-onset mushrooms cause anticholinergic effects,
including drowsiness, followed by mania and hallucinations. Another subgroup of
early-onset mushrooms produces a severe gastroenteritis syndrome.
Hallucinogenic mushrooms such as those containing psilocybin make up another

class of mushrooms with early-onset symptoms. Finally, some mushrooms
precipitate a disulfiram-like reaction if they are coingested with alcohol.
Management for all these agents consists of supportive care and careful
monitoring of fluid status.