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The year is 2012 and a Korean man
rushes into the emergency department
after 10 days of suffering a fever
and watching the skin separate from
his palms, the soles of his feet and
his scalp. He had a medical history
of hypertension, which he was
currently taking medication for. Upon
admission, his vital signs included
low blood pressure, an elevated heart
rate and an elevated body temperature
of thirty eight point two degrees
Celsius.

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The patient complained of symptoms
including general weakness, a sore
throat, a minor headache, a fever and
chilling sensations. He wasn't
suffering from any chest pain,
dyspnea, abdominal pain or diarrhoea.
Nor was he suffering symptoms of
Paresthesia, the sensation of pins
and needles, or tingling, or pricking
in their arms, hands, legs or feet,
nor visual disturbance i.e.
hallucinations.

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Doctors carried out a physical
examination of the patient, which
revealed an alert mentality, poor
skin turgor, suggesting dehydration,
as well as a dried tongue and lips,
skin peeling on the palms and soles
and hair loss. Doctors extracted
blood from the patient and analyzed a
complete blood count, which came back
in the normal ranges, except for a
low white blood cell count, which
could be caused by any number of
different infections.

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A chest x-ray was taken and revealed
no abnormal findings and a C.T. scan
was also taken of the abdominal
pelvic region in search of an
infection, but came back with no
obvious signs of any sickness.
Doctors believed the patient may be
suffering from streptococcus toxic
shock syndrome, a disease whereby a
bacterial infection produces toxins
that poison the body and, so the
patient was given fluids
intravenously, including a number of
different antibiotics and antibodies
to help fight any infection and boost
the patient's immune system.

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However, on day two of
hospitalization, the patient's high
temperature remained and his blood
counts had further dropped. On day
three the patient began to complain
of shortness of breath and his
respiratory rate climbed to thirty
breaths per minute. Doctors placed a
breathing tube in the patient
supplying him with two litres of
oxygen per minute. However, multiple
organ failure was beginning to set
in. The doctors decided to rush
another chest X-ray, which now showed
newly developed consolidations in
both of the lower lung regions. The
race was now on to save the patient's
life as his health was quickly
deteriorating.

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They changed the patient on to three
new antibiotics in the hopes of
treating his pneumonia and what they
still suspected was neutropenic
severe sepsis, the presumed bacterial
infection that he had somewhere.

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00:03:09,170 --> 00:03:27,305
On the same day, a 60 year old woman
was hospitalized suffering a sore
throat and a fever. It was the wife
of the male patient who'd arrived two
days earlier. Upon her admission, the
woman's vitals were similar to that
of her husband's, only a few days
earlier with an elevated heart rate
and body temperature.

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She had no previous medical or
medication history, she suffered no
symptoms of dyspnea, abdominal pain,
vomiting, diarrhoea Paresthesia.
Similar to her husband, a physical
examination found she had an alert
mentality, a dried tongue and lips
and a rash on her lower extremities,
except without separation of the skin
on her hands and feet like her
husband was suffering.

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Her blood count results mirrored
those of her husband and as such she
was given a transfusion of platelet
concentrate and antibiotic therapy
was initiated. All other laboratory
and image tests indicated no signs of
any other problems.

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00:04:07,605 --> 00:04:24,391
By day four, the husband was moved to
the intensive care unit as he began
to suffer from acute respiratory
distress syndrome. He couldn't
breathe on his own anymore and he was
suffering from acute renal failure.
His kidneys were no longer cleaning
his blood of toxins.

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In intensive care, the husband
received mechanical ventilation to
assist his breathing and he required
constant renal replacement therapy.
Day five only saw the husband's
condition decline further and by day
six he had died as a result of
intractable multiple organ failure.
Due to the wife's clinical
manifestations developing in a
similar pattern to that of her now
deceased husband's, doctors
questioned her about her medical
history concerning previous
medications. What they ultimately
discovered was telling. They found
out that the couple had harvested and
dried wild mushrooms from a nearby
forest, which had then been boiled
into a tea, which the couple drank on
a daily basis in the place of plain
water.

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The problem was the fungi the couple
had been targeting was a fungus
called Ganoderma lucidum, a
non-toxic, perfectly safe fungus to
consume. However, the medical team
weren't going to take any chances
with their second patient for fear
that she may suffer the same fate as
her late husband. They asked the
Agricultural Microbiology Team of the
National Academy of Agricultural
Science in Korea to examine the
patient's remaining mushrooms.

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The team received a bag of dried
mushrooms, which had been used as a
source for the tea. They searched
through the collection of dried up
brown pieces of fungus, which were
long, thin and flat in shape with
many pieces having a light brown or
white stripe along one edge, clearly
identifying them as being the species
Ganoderma lucidum.

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Just as the team was about to
complete their assessment, someone
noticed a slightly different piece.
This piece was long and thin, but
instead of being flat, it was round
like a worm or a thick cord or cable.

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The team separated it out from the
others ran some tests and discovered
to their horror then instead of being
Ganoderma lucidum, this small noodle
shaped piece of dried up fungus was
the deadly species of fungus
Podostroma cornu-damae, or the poison
fire coral fungus.

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The medical team now had their
culprit although unfortunately
several people have died from
consuming the poison fire coral
fungus in the past, very little is
still known about the fungus, the
toxins it produces, and there remains
no known cure.

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The female patient was now suffering
from an incredibly low white blood
cell count and, as a result, the
medical team carried out a bone
marrow biopsy on day eleven,
revealing hypocellular marrow, less
than 10 per cent density. The initial
blood cultures showed no growth of
any microorganisms, which suggested a
poison and not a bacterial or viral
infection was to blame for the
symptoms of the woman.

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On top of this, the woman's fever was
still persisting and, so more
antibiotics were administered in an
attempt to treat the patient's fever
and low blood cell count. On day 24,
nearly a fortnight later, the
patient's white blood cell count was
back to normal and a fever had
subsided. On day 25, the medical team
stopped administering antibiotics and
two days later, nearly a month after
she first arrived at the hospital
alongside her husband, she was
discharged without any further
complications.

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The Poison Coral fungus, or
Podrostoma cornu-damae, was first
discovered in China back in the year
1895. It was originally described as
Hypocrea cornu-damae and then later
placed into the genus Podostroma by a
Japanese mycologist. The fungus is
known to exist in Japan, China, Java
and also in Korea and now the
tropical rainforests of Far North
Queensland in Australia, where it was
found just a few weeks ago.

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It's shaped like a deer's horn or
like stag horn coral, which also
references a deer's horn, and is
usually a vibrant iridescent red
colour. To the misfortune of the
occasional mushroom picker, in its
immature period, this incredibly
toxic fungus resembles the otherwise
benign and non-toxic fungus Ganoderma
lucidum, which is often harvested for
use as a health food.

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Fungus toxins are usually found in
their fruit bodies, known as
'ascocarp' or 'ascoma', which are
usually the parts of the fungus you
see above the ground like mushrooms
and truffles, but the parts that only
appear seasonally usually during
spring, which house the fungus
spores, the equivalent of the plant
seeds, which are then released into
the air, picked up by the wind and
distributed around the surrounding
area to spread the fungus. As you're
probably aware, many types of fungi
toxins or micro toxins, which if
ingested can make the consumer
hallucinate, sick or even kill them,
and surprisingly, with the many
thousands of species of fungus known
to science distributed throughout the
world, only 30 species are known to
be fatally poisonous.

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Intriguingly, Podostroma cornu-damae
is the only fungus known to be
poisonous to the touch, where if you
touch it with your bare skin, it can
cause dermatitis a reddening or
swelling of the skin. As outlined in
the story at the beginning of this
episode, the poison fire coral fungus
can kill when even the most minute
part of it is consumed. Other stories
of misadventures with the fungus
include back in 1999 a group of five
people in Japan ate one gram of
Podostroma cornu-dame, that they
found soaking in sake. One of the
five died two days later after
consuming the tainted sake.

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Another report described 13 cases of
accidental ingestion of several
centimetres of Podostroma from the
year 1983 to 2008, where two of the
victims ended up dying. Therefore,
it's clear now that ingesting even
the most minute amount of this
mushroom could prove to be fatal.

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How does the fungus kill you?

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Although we don't know the specifics
of how the cocktail of different
mycotoxins from the poison fire coral
kills people, we do have a list of
the most common symptoms of
poisoning, which are horrifying. They
include: diarrhoea, vomiting, and
dehydration in the early stage. This
is followed by hypertension, oliguria
(low urine output), changes in
perception, and disturbance of
consciousness.

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Without treatment, your white blood
cell and platelet count plummets, you
experience lamellar desquamation on
the face palms and soles of your
feet, this is where the skin
separates from your body and your
hair starts to fall out, the most
severe symptoms experienced prior to
death, as things advance include, the
shrinking of the brain with nerve
dysfunction, multiple organ failure
including acute renal injury, liver
necrosis, and disseminated intra
vascular coagulation, which is a
fancy term for the blood clotting in
your arteries and veins throughout
your body.

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Although we currently understand the
conditions and the chemical
background of this poisonous fungus,
there still remains no curative
treatment available.

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So, why did I pick this story today?

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I thought it was fascinating because
I saw in the media this week that the
poison fire coral fungus was found in
Australia. The poison fire coral
fungus was thought to be native to
South East Asia, only being recorded
in places like Japan, China, Korea
and Indonesia.

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However, this week it obtained
Australian notoriety in the news when
it was discovered in suburban Cairns,
in far north Queensland Australia.
How it got there completely
bamboozled and baffled scientists.
The answer they came to was it's a
natural occurrence, massively
extending the known range of this
deadly species of fungus. It further
highlights the limited knowledge of
fungi in northern Australia.

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So, before we finish up, I thought I
might talk about why some fungi are
poisonous. Fungi in general are just
really good chemists, who make lots
of different compounds.
Evolutionarily speaking, they've
evolved this ability in order to
fight for survival and reproduction
in a hostile world. This is why many
of our antibiotics, such as
penicillin, chemicals used to kill
microbes like bacteria, have been
discovered in species of fungi
because they've developed these
chemicals to defend themselves from
infection and predation.

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The fruit bodies of fungi are the
part of the organism that appears
above the ground, usually in spring,
when it's time to produce spores and
complete the reproductive cycle.
Being above ground means you can be
more easily found and eaten by
animals like deers, bears, rabbits,
birds, insects or even people. One
way to avoid detection from such
hungry critters may be to appear in
drab colours, light or dark greens,
or browns. This can help mushrooms
fade away into the natural
environment.

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Another way is to generate toxins
within these mushrooms that when
eaten make the consumer sick or even
kill them, which in evolutionary
terms hopefully sends a message to
the species saying 'steer clear of
me' and the cherry on the cake is
adding bright colours, doing the very
opposite of camouflaging yourself,
but instead making yourself as
conspicuous as possible against the
drab natural background as a warning
sign to any would be predators saying
'stay away. I'm incredibly visible
and not afraid to be found because
I'm incredibly poisonous, I want you
to notice me and keep the hell away'.

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From many animal species behave the
same way such as poison arrow frogs
and venomous snakes, spiders, and
insects. Ultimately, when you're
highly poisonous as a defence, it's
better for you to be noticed and
avoided and be eaten and killed,
whether or not the culprit dies
shortly after or not. So, the basic
moral of the story is: don't eat
fungi that you find in nature unless
you're 100 per cent certain, you know
what you're doing, and beyond that if
it's brightly coloured, it might be
best to steer clear.