Mushroom poisoning by Chlorophyllum molybdites in the Midwest United States. Cases and a review of the syndrome.

The paper describes two incidents of poisoning by the mushroom Chlorophyllum molybdites and reviews the literature covering this organism, a common agent of mushroom poisoning in many countries and the most common cause of mushroom poisoning in North America. Both poisoning incidents occurred in adults and were associated with severe gastrointestinal symptoms including profuse diarrhea, vomiting and intestinal pain. In each case, hospitalization was required. An unusual aspect of one case was the development of signs and symptoms suggestive of muscarine poisoning. The review includes a description of the mushroom, the geographic distribution of cases, the signs and symptoms of poisoning and its treatment, the toxic principles, particularly susceptible populations, and the variations in response associated with cooking C. molybdites and with individual idiosyncrasies. For identification of C. molybdites, the reader is alerted to the inappropriateness of some books, including many written in Europe, and is warned of the occasional finding of sterile mushrooms that lack its characteristic green basidiospores. Spores, as allergens, are discussed and simple rules are given for eaters of wild mushrooms.