About This Guide
This guide covers the 5 most clinically significant toxic mushroom species in Central and North-Western Russia, with a focus on hepatocellular necrosis via amatoxins — the dominant and most lethal toxidrome in this region. Amanita phalloides (Бледная поганка) and Amanita virosa (Белая поганка) are responsible for the majority of fatal mushroom poisonings in European Russia.
Emergency contacts (tap to call): Emergency 112 • Ambulance 103 • Moscow Poison Control +7 (495) 628-16-87 • St. Petersburg (Dzhanelidze Institute) +7 812 388 48 50
Quick Reference — All 5 Species
| Species | Common Name | Tier | Toxin | Onset | Primary Risk |
|---|---|---|---|---|---|
| Amanita phalloides | Death Cap / Бледная поганка | Tier 1 | Amatoxins (α-amanitin) | 6–24h GI / 48–96h hepatic | Fulminant hepatic necrosis / MOF |
| Amanita virosa | Destroying Angel / Белая поганка | Tier 1 | Amatoxins | 6–24h latent / 3–5 days hepatorenal | Fulminant hepatic failure |
| Amanita verna | Spring Death Cap | Tier 1 | Amatoxins | Triphasic — same as phalloides | Fulminant hepatic necrosis |
| Galerina marginata | Deadly Galerina | Tier 1 | Amatoxins (α-amanitin) | Same as Amanita — often missed | Fulminant hepatic necrosis |
| Lepiota brunneoincarnata | Deadly Dapperling | Tier 1 | Amatoxins | Triphasic progression | Fulminant hepatic failure |
Identification: Pale olive-green/yellowish/white cap (5–15 cm), white free gills, membranous ring, large bulbous volva at base.
Look-alike risk: Green russulas (Russula virescens / Сыроежка зелёная) or white field mushrooms (Agaricus campestris / Шампиньон луговой).
Treatment: IV fluids (urine output 100–200 mL/hr). Activated charcoal 1 g/kg every 4 hrs via NG. IV Silibinin 20–30 mg/kg/day or Benzylpenicillin 1,000,000 units/kg/day. Note: IV silibinin may be unavailable in many Russian regional hospitals. In those settings, N-acetylcysteine (NAC) and benzylpenicillin are the established alternative protocols. Full NAC protocol. Monitor PT/INR, AST/ALT, bilirubin, creatinine every 6 hrs. Prepare for urgent liver transplant if King's College criteria met.
Identification: Pure white cap, gills, and stalk. Large bulbous volva. Faint sweet odor.
Look-alike risk: Button mushrooms (Agaricus), edible Amanita species.
Treatment: Same as Amanita phalloides — IV Silibinin, multiple-dose activated charcoal, NAC protocol, liver transplant evaluation. Note: IV silibinin may be unavailable in many Russian regional hospitals. In those settings, N-acetylcysteine (NAC) and benzylpenicillin are the established alternative protocols.
Identification: All-white mushroom with volva at base. Resembles edible white Amanita species.
Identification: Small brown cap (1–4 cm), ring on stalk, grows in clusters on wood.
Look-alike risk: Pholiota species, edible honey mushrooms (Armillaria / Опёнок).
Identification: Small cap (3–8 cm) with brown concentric scales on white background. Ring present.
Look-alike risk: Edible Lepiota species, field mushrooms.