{"id":954,"date":"2016-05-05T18:11:55","date_gmt":"2016-05-05T16:11:55","guid":{"rendered":"http:\/\/digipathblog.wordpress.com\/?p=4"},"modified":"2021-01-11T14:45:52","modified_gmt":"2021-01-11T12:45:52","slug":"of-mushrooms-and-men","status":"publish","type":"post","link":"https:\/\/blogs.uct.ac.za\/digipathblog\/2016\/05\/of-mushrooms-and-men\/","title":{"rendered":"Of mushrooms and men"},"content":{"rendered":"<p style=\"text-align: justify;\">Of the many natural hazards in Africa, mushrooms are not necessarily the first thing to spring to mind. But&nbsp;Neil van der Reij,&nbsp;a mushroom researcher with the Department of Agriculture and Environmental Affairs, is quoted as saying mushroom poisoning is &#8220;common&#8221; in South Africa (1).<\/p>\n<p style=\"text-align: justify;\">In our collection we have two liver specimens titled &#8220;mushroom poisoning&#8221;. Each case is noted to be &#8220;one of a whole family who were poisoned by eating mushrooms&#8221;. The incident occurred in Cape Town in May of 1927.<\/p>\n<figure id=\"attachment_881\" aria-describedby=\"caption-attachment-881\" style=\"width: 276px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-881\" src=\"http:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/xviii_vii_6.jpg?w=273\" alt=\"XVIII_VII_6\" width=\"276\" height=\"304\"><figcaption id=\"caption-attachment-881\" class=\"wp-caption-text\"><a href=\"https:\/\/digitalpathology.uct.ac.za\/case_detail.php?case_id=1644\">The preserved liver of the last of a family of 7 who died of mushroom poisoning in Cape Town in 1927.<\/a><\/figcaption><\/figure>\n<p style=\"text-align: justify;\">The original&nbsp;post-mortem reports&nbsp;add minimal non-pathological&nbsp;details, so&nbsp;over&nbsp;the Christmas period I took the time to browse the archive of&nbsp;the The Cape Argus for more about the story. Sure enough,&nbsp;a&nbsp;report appeared&nbsp;on 16 May, the day after the the entire family was&nbsp;admitted to Somerset Hospital. Subsequent updates documented&nbsp;the deaths of first the mother, followed by five&nbsp;children aged&nbsp;2 to&nbsp;14 years, then the father,&nbsp;and finally the 18-year-old stepson&nbsp;on May 19. According to the paper, the destitute family had recently arrived in Cape Town and were staying in a boarding house. Apparently&nbsp;they were relying on the kindness of neighbours&nbsp;for food. One Sunday morning the father and his elder&nbsp;stepson climbed the foothills of Table Mountain above the city, where they found mushrooms &#8211; it appeared&nbsp;these were eaten after being boiled, and symptoms set in after&nbsp;only a few hours. At post-mortem, the pathology was primarily fatty degeneration of the liver, kidneys and heart, resulting in multi-organ failure. The only family members to survive&nbsp;were the&nbsp;3-month-old baby and a little girl who had been adopted by friends a few weeks before the incident.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-853\" src=\"http:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/18-may-1927-_.jpg\" alt=\"18 May 1927 _\" width=\"1532\" height=\"3137\" srcset=\"https:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/18-may-1927-_.jpg 1532w, https:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/18-may-1927-_-147x300.jpg 147w, https:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/18-may-1927-_-768x1573.jpg 768w, https:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/18-may-1927-_-500x1024.jpg 500w\" sizes=\"(max-width: 1532px) 100vw, 1532px\" \/><\/p>\n<p style=\"text-align: justify;\">Of all the cases in our collection, why do&nbsp;these resonate particularly? Aside from being terribly sad events, there is something fascinating about natural poisoning whether by&nbsp;snakes, arachnids, plants or&nbsp;funghi.&nbsp;My&nbsp;quick search of the web found media accounts of 16&nbsp;fatal cases of mushroom poisoning (in 5&nbsp;clusters) in South Africa between 2008 and 2014. In addition, in 2001 a child poisoned by mushrooms was saved by a liver transplant at Red Cross Children&#8217;s Hospital, but her grandfather succumbed (2). Going back 100 years,&nbsp;it is part of Southern Cape history that the prominent businessman who founded the village of Wilderness died there as a consequence of eating mushrooms he had collected locally; his sister and a guest succumbed too (3).&nbsp;Medical&nbsp;reports&nbsp;can be found in the SAMJ archive:&nbsp;In 1955, five of nine related&nbsp;patients died in Ermelo, and in 1988, four of five patients died in&nbsp;the Ciskei after apparently sharing a single mushroom (4,5).<\/p>\n<p style=\"text-align: justify;\">One wonders how many other cases go unrecognised.<\/p>\n<p style=\"text-align: justify;\">Frustratingly, only the more recent end of the SAMJ archive is searchable, but by chance I discovered that a report of our own mushroom poisoning cases was&nbsp;published in November 1927 by&nbsp;<a href=\"http:\/\/archive.samj.org.za\/1927%20VOL%20I%20Jan-Dec\/11%20November\/1.2%20NOTES%20ON%20CASES%20OF%20FUNGUS%20POISONING.%20S.F.%20Silberbauer%20and%20L.%20Mirvish.pdf\">Mervish and Silberbauer<\/a> (well known Cape doctors), including the post mortem notes&nbsp;of Prof JB Ryrie (6). They conclude their paper with an account of experiments they conducted on a frog heart and rabbit intestine, using the vomitus of the patients.<\/p>\n<p style=\"text-align: justify;\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-948 alignright\" src=\"http:\/\/blogs.uct.ac.za\/digipathblog\/wp-content\/uploads\/2016\/05\/mush-book-cover-1.jpg?w=213\" alt=\"mush book cover\" width=\"224\" height=\"317\"><\/p>\n<p style=\"text-align: justify;\">There is a pattern to&nbsp;these poisoning incidents; they all involve clusters of family and sometimes extend to friends as well, because a meal, with or without mushrooms, is usually shared. Also in common is that all the incidents were known or assumed to have involved <em>Amanita phalloides<\/em>, and the course to death was agonising. In the Cape, mushroom poisonings mostly&nbsp;occur in April\/May, while in the rest of the country they occur during the months of summer rainfall.&nbsp;The 2016 mushroom season in Cape Town is now open for those of us who dare forage!<\/p>\n<p>See also<\/p>\n<p><a href=\"http:\/\/www.pathologylearningcentre.uct.ac.za\/harmful-substances-fungi\">www.pathologylearningcentre.uct.ac.za\/harmful-substances-fungi<\/a><\/p>\n<p style=\"text-align: justify;\">SOURCES<\/p>\n<ol style=\"text-align: justify;\">\n<li><a href=\"http:\/\/www.iol.co.za\/news\/south-africa\/kwazulu-natal\/mushroom-poisoning-common-in-sa-1390479\">http:\/\/www.iol.co.za\/news\/south-africa\/kwazulu-natal\/mushroom-poisoning-common-in-sa-1390479<\/a><\/li>\n<li><a href=\"http:\/\/www.iol.co.za\/news\/south-africa\/poisoned-girl-gets-christmas-gift-of-life-78523\">http:\/\/www.iol.co.za\/news\/south-africa\/poisoned-girl-gets-christmas-gift-of-life-78523<\/a><\/li>\n<li><a href=\"http:\/\/www.georgeherald.com\/news\/News\/General\/162148\/Centenary-of-poison-mushroom-deaths\">http:\/\/www.georgeherald.com\/news\/News\/General\/162148\/Centenary-of-poison-mushroom-deaths<\/a><\/li>\n<li>Steyn DG, Steyn DW, Van der Westhuizen GC, Louwrens BA. Mushroom poisoning. S Afr Med J. 1956; 30:885-890<\/li>\n<li>Rivett MJ, Boon GP. Mushroom (Amanita phalloides) poisoning in the Ciskei.&nbsp;S Afr Med J. 1988;73:317.<\/li>\n<li><a href=\"http:\/\/archive.samj.org.za\/1927%20VOL%20I%20Jan-Dec\/11%20November\/1.2%20NOTES%20ON%20CASES%20OF%20FUNGUS%20POISONING.%20S.F.%20Silberbauer%20and%20L.%20Mirvish.pdf\">Silberbauer SF, Mervish L. Notes on cases of fungus poisoning. J Med Assoc S Afr. 1927; 1(21): 549-553<\/a><\/li>\n<\/ol>\n<p style=\"text-align: center;\"><em>Dedicated to my colleague, friend and mushroom guide, DRH.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Of the many natural hazards in Africa, mushrooms are not necessarily the first thing to spring to mind. But&nbsp;Neil van der Reij,&nbsp;a mushroom researcher with the Department of Agriculture and [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"ngg_post_thumbnail":0,"footnotes":""},"categories":[16,4],"tags":[9,5,18],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Of mushrooms and men - digital pathology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.uct.ac.za\/digipathblog\/2016\/05\/of-mushrooms-and-men\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Of mushrooms and men - digital pathology\" \/>\n<meta property=\"og:description\" content=\"Of the many natural hazards in Africa, mushrooms are not necessarily the first thing to spring to mind. 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