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Abstract

Although mushroom poisonings or “mycetisms” occur more frequently than is commonly recognized, they are often misdiagnosed due to their relative rarity, diverse clinical presentations, and the broad chemical variety of the toxins involved. More than a hundred different mushroom-derived toxins have been identified to cause at least 14 different poisoning syndromes or “toxidromes”, several of which can result in death through means such as organ failure. Understanding the toxicology of these mushroom toxins is essential for diagnosis in both clinical and forensic settings. Modern analytical techniques, such as liquid-chromatography–tandem mass spectrometry (LC–MS/MS) and enzyme-linked immunosorbent assays (ELISA), have improved the identification of specific toxins in biological samples, though issues such as degradation of toxin and delayed presentation limit confirmation. This paper summarizes current knowledge of the most well-known poisonous mushrooms and their respective toxins, examining differences in structure, mechanism, and toxicological detection, which are all essential in improving diagnostic accuracy, guiding forensic investigations, and advancing future research.

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