How to use this guide
This reference covers the 8 most clinically significant toxic mushrooms found in Saskatchewan and Manitoba prairie, parkland, and boreal-edge ecosystems. Species are organized by toxicological severity. Onset times, toxin mechanisms, and treatment protocols are included for emergency department and poison control use. Veterinary notes are provided for all Tier 1 and Tier 2 species. This guide is not a field identification tool — confirmation should come from a certified mycologist or poison control specialist.
Saskatchewan Poison Control Centre: 1-866-454-1212 | Manitoba Poison Centre: 1-855-702-4222
| Species | Tier | Toxin | Onset | Key Symptom |
|---|---|---|---|---|
| Amanita magnivelaris / A. amerivirosa | Tier 1 | Amatoxins | 6–24h | Fulminant hepatic necrosis |
| Cortinarius orellanus group | Tier 1 | Orellanine | 3–14 days | Oliguric AKI |
| Clitocybe rivulosa | Tier 2 | Muscarine | 15–30 min | SLUDGE / bronchospasm |
| Galerina marginata | Tier 2 | Amatoxins | 6–24h | Hepatic necrosis |
| Paxillus involutus | Tier 2 | Hemolytic immune complex | 30 min–2h (repeat) | Hemolytic anemia / shock |
| Amanita muscaria / A. pantherina | Tier 3 | Ibotenic acid / Muscimol | 30 min–2h | CNS depression / delirium |
| Chlorophyllum molybdites | Tier 3 | GI toxins | 1–3h | Hemorrhagic gastroenteritis |
| Lycoperdon / Bovista spp. | Tier 3 | Variable | Variable | Amanita button risk |
Phase 1 (6–24h): Violent rice-water diarrhea and cramping. Patient appears severely ill.
Phase 2 (24–48h): False recovery — patient feels better and may request discharge. Biochemical tracking shows rising AST/ALT during this window. This is the critical diagnostic trap — do not discharge.
Phase 3 (3–5 days): Fulminant hepatic necrosis, encephalopathy, coagulopathy, renal failure.
Treatment: Aggressive IV fluid resuscitation. Multi-dose activated charcoal (MDAC) to interrupt enterohepatic circulation. IV Silibinin (Legalon SIL) if available. N-acetylcysteine (NAC) protocol. Early contact with University of Alberta Hospital Liver Transplant Team (regional referral centre for amatoxin cases). Repeat LFTs every 6–8 hours throughout all phases.
Symptoms: Intense thirst (polydipsia), burning mouth, lumbar flank pain, chills, followed by oliguric or anuric acute kidney injury (AKI).
Treatment: Early nephrology consultation. Serial creatinine tracking. Hemodialysis or CRRT if uremia or hyperkalemia develops. No specific antidote — supportive renal care is primary management.
Symptoms: SLUDGE syndrome — Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis. Severe miosis, bradycardia, bronchospasm. Classic cholinergic toxidrome.
Treatment: Atropine 0.5–2mg IV, titrated strictly until bronchial secretions dry and airway clearance is achieved. Repeat dosing as needed. Monitor cardiac rhythm. This is one of the most common serious prairie mushroom poisonings because Marasmius oreades (Fairy Ring) is among the most popular edible mushrooms on prairie lawns and both species fruit in the same rings.
Treatment: Apply full amatoxin protocol: IV fluid resuscitation, MDAC, IV Silibinin if available, NAC protocol, repeat LFTs every 6–8 hours. Contact University of Alberta Hospital Liver Transplant Team early for confirmed cases.
Symptoms: Acute severe immune-mediated hemolytic anemia, hemoglobinuria, jaundice, shock, secondary acute tubular necrosis. First ingestion is often symptom-free — symptoms worsen with each subsequent ingestion.
Treatment: RBC transfusions. Plasmapheresis in severe presentations. Aggressive fluid diuresis to protect renal tubules from free hemoglobin. Systemic corticosteroids.
Symptoms: Alternating CNS depression (coma-like stupor) and CNS stimulation (delirium, manic agitation, muscle twitching). Presentation can oscillate unpredictably.
Treatment: Supportive airway management. Benzodiazepines (e.g., Lorazepam) for severe agitation or seizures.
Symptoms: Violent, explosive, often hemorrhagic vomiting and diarrhea. Hypovolemic shock in severe cases.
Treatment: Aggressive IV fluid volume resuscitation. Antiemetics. Monitor for hemodynamic compromise.
Slice lengthwise before eating any puffball. Solid, unblemished white marshmallow-like interior confirms a true puffball — safe to eat.
Any outline of a miniature stem, cap, or gills indicates a deadly embryonic Amanita button — discard immediately and do not eat.
This simple check should be performed on every puffball before any preparation. Prairie foragers, new Canadians, and children collecting "white balls" are the highest-risk groups for this error.