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Scleroderma citrinum
General Details, Taxonomy and Biology, Clinical Effects, First Aid
Scleroderma citrinum ( Common earth ball Poison puffball  )  [ Original photo copyright © Jens V Petersen ]
Phylum: Basidiomycota
Class: Basidiomycetes
Order: Boletales
Family: Sclerodermataceae
Genus: Scleroderma
Species: citrinum
Clinical Group: GROUP 5 - Gastrointestinal irritant mushroom poisoning
Common Names: Common earth ball, Poison puffball
Mycorrhizal fungus found on acid soils in deciduous and coniferous forests, pine forests, heaths and moors and edges of woodland. Usually gregarious. Found from summer to late autumn.
FRUITING BODY 2-12 cm diameter, sub-globose, bulbous to transversely ovoid, flattened, firm. Often mycelial strands at the base form a short root like appendage. Peridium very thick, 4 mm, solid. Surface rough, scaly and warty, creamy yellow, inside whitish to brownish, sometimes reddish orange. Inner mass is initially fleshy, white, compact, when freshly cut reddish white, when spores mature violet to black interspersed with whitish veins, finally the whole mass decay in to powder, it will remain inside until the peridium in damaged.

SPORE PRINT dark greenish brown.

Spores 8-13 μm, globose, with reticulate ornamentation, 1-6 μm high spines. Clamp connections present at septa of peridial hyphae.
First Aid
Description: First aid for poisoning by plants or mushrooms where no agreed first aid method is currently available.
In the absence of research or clinical data about first aid for poisoning caused by this species, no first aid method can currently be recommended. Seek Medical Advice without delay.
Clinical Effects & Treatment
Clinical Classification
Group 5 - Gastrointestinal irritant mushroom poisoning
Indole compounds maybe present
Clinical Effects Overview
A wide variety of mushrooms can induce gastrointestinal irritation when ingested. Such GIT effects are the most common type of mushroom poisoning. The clinical presentation may differ between groups. The following is an overview of this whole class of poisonous mushrooms, where diverse toxins are involved, but with similar clinical profiles.

Poisoning follows ingestion of either raw or cooked mushrooms, though cooking can reduce toxicity in some cases. Symptoms of GIT disturbance commence 1-3 hrs post-ingestion and can include vomiting, abdominal pain and diarrhoea. The diarrhoea may be profuse and may become bloody, especially after consumption of Chlorophyllum molybdites. GIT fluid loss can be severe and can cause secondary hypovolaemic shock, especially in children. Secondary problems are possible in this latter setting, such as DIC and renal failure and fatalities have occurred, notably in children. However, for most patients, this is an unpleasant but self-limited illness, with resolution of symptoms after 3-4 hrs in many cases. A few species cause longer lasting effects, taking up to 48 hrs to resolve in some cases.

Apart from the risk of massive GIT fluid loss and its complications, the major risk relates to unsuspected co-ingestion of more toxic species, such as amatoxic mushrooms.
Primary Clinical Effect
The primary effect is short-lived gastrointestinal irritation.
Treatment Overview
Most cases of gastrointestinal irritant mushroom ingestion will develop a self limited illness and recover over a period of hours, with no more than simple supportive care, notably fluid replacement.

Only a minority of cases will have severe GIT fluid loss requiring full resuscitation with IV fluids and, on occasion, pressors. A further small subset will develop hypovolaemic shock and complications thereof, requiring more substantial intervention.

The major risk is undocumented co-ingestion of more toxic mushrooms, such as amatoxic species.
Scleroderma citrinum ( Common earth ball Poison puffball ) [ Original photo copyright © Jens V Petersen ]
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