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Poison Mushroom Victim Saved by Liver Transplant

Times Staff Writer

A 19-year-old Oakland woman who shared a meal of freshly picked wild mushrooms with a companion was in critical condition at UCLA Medical Center on Thursday after a seven-hour liver transplant operation that apparently saved her life, authorities said.

The case is the second in the nation in which surgeons have replaced a liver to treat a life-threatening case of mushroom poisoning, one expert said.

The man who picked and ate the mushrooms with the young woman was in serious condition as UCLA doctors monitored him to see if he, too, would need the complex transplant surgery.

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“The liver transplant has become a procedure that is more widely performed in recent years, so it’s become an opportunity for (doctors) to save some of the people who otherwise would have died” of mushroom poisoning, said Dr. Kent R. Olson, director of the San Francisco-Bay Area Regional Poison Center.

Cynthia Zheng, who received a new liver on Wednesday, and Wilhelm Winter, 45, also of Oakland, mistakenly picked lethal Death Cap mushrooms last Friday during an outing near Inverness in Marin County, just north of Point Reyes Station, an Alameda County health official said.

“They harvested some mushrooms which they sauteed in garlic and butter. They apparently tasted very delicious,” said Dr. Robert Benjamin of the Alameda County Health Care Services Agency.

A former landlord said Zheng and her mother moved to California from China within the last few years. The landlord, Charles Wilkins, said Zheng is an exceptionally bright young woman who holds several part-time jobs and is a freshman at Laney College in Oakland.

“She had gone to high school for a couple of weeks and they said she didn’t belong there,” Wilkins said. “I know that she cooked Chinese food that smelled good. I know she used herbs, ginger and things like that.”

A neighbor said Winter is from Austria, and moved to his home on Oakland’s Loma Vista Avenue more than a dozen years ago. She described him as a quiet man who “was by himself most of the time.” She said she does not know what Winter does for a living.

Zheng and Winter relied on a field guide containing pictures of dangerous mushrooms when they went picking, Benjamin said. “The problem is that not all mushrooms look exactly like that particular picture in the book,” he said.

On Saturday morning, Benjamin said, Zheng went to the emergency room at Highland Hospital in Oakland, complaining of abdominal cramps, nausea and diarrhea. She brought samples of the mushrooms she and Winter had eaten the night before.

The samples were analyzed and determined to be Amanita phalloides , one of a group of mushrooms that contain a deadly toxin that kills liver and kidney cells, Benjamin said. The fatality rate among those who eat A . phalloides is between 30% and 50%, he added.

“It’s important for people to understand that this poison is not deactivated by heating, so it can be cooked and it is just as deadly,” Benjamin said. “There is no antidote.”

Winter, who had not yet become ill, was summoned to the hospital and later began showing symptoms of poisoning. Zheng, meanwhile, lapsed into a coma. With Zheng still unconscious, the two were flown from Highland Hospital to UCLA Medical Center on Tuesday, authorities said.

UCLA was chosen because it was the closest facility that was prepared to perform immediate liver transplants, said UCLA Medical Center spokesman Michael Byrne. Zheng regained consciousness after the transplant operation, which ended at 9:30 a.m. Wednesday, Byrne said.

Benjamin speculated that Winter’s illness did not come on as suddenly or severely as Zheng’s because of his relatively larger stature. “She is very slight and I am told that he is heavier,” he said.

Physicians at the Sacramento Medical Center at the University of California, Davis, performed liver transplant surgery in February, 1983, on a little girl who had eaten potentially deadly mushrooms, said Olson of the San Francisco poison center. The operation was successful, he said.

In the last 10 years, 32 Californians have become ill after eating mushrooms containing amatoxin, the most deadly of the mushroom poisons, Olson said. Of those victims, five died, he said.

Records complied by the California Department of Health Services indicate that, since 1980, 53 Californians have fallen ill after eating some type of poisonous mushroom. The cases stemmed from 14 separate incidents. The department had no available figures on deaths.

Of approximately 5,000 species of mushrooms that grow in the United States, about 100 are poisonous and 10 are potentially lethal.

The amatoxin found in the Death’s Cap and related mushrooms can produce signs of illness within six to 24 hours, said Dr. Robert A. Murray, an epidemiologist with the state health department. “Then there can be a period of remission, and after that, the liver starts to be destroyed. That’s what killed people.”

The Death Cap mushroom, also known as Death Cup or Death Head, is found throughout California, authorities said, although it is more common in moist areas near the coast.

The incidence of mushroom poisoning often depends on the weather, several officials said. Last year, which was relatively dry, there were no reported cases of mushroom poisoning in California, according to state records.

“This year, there were early rains, then a warm spell, then rains again,” Olson said. That type of weather cycle promotes the growth of all mushrooms, including the toxic varieties. “If you look over the 10-year average of three to five or fewer cases (of amatoxin poisoning) a year, you can see it’s quite variable,” he said.

The best advice for would-be mushroom pickers, Benjamin said, is don’t.

“There is an old adage,” he said. “There are old mushroom hunters, and there are bold mushroom hunters. But there are no old, bold mushroom hunters.”

Times staff writer Dana Nichols in San Francisco contributed to this story.


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