1 00:00:15,470 --> 00:00:44,630 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. 2 00:00:45,260 --> 00:01:04,517 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. 3 00:01:12,061 --> 00:01:40,230 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. 4 00:01:41,000 --> 00:02:16,144 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. 5 00:02:16,880 --> 00:02:54,710 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. 6 00:02:55,610 --> 00:03:08,270 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. 7 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. 8 00:03:27,980 --> 00:03:52,039 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. 9 00:03:52,610 --> 00:04:04,076 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. 10 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. 11 00:04:25,040 --> 00:05:09,139 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. 12 00:05:10,010 --> 00:05:31,570 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. 13 00:05:37,885 --> 00:06:05,684 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. 14 00:06:06,880 --> 00:06:18,677 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. 15 00:06:19,390 --> 00:06:32,522 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. 16 00:06:37,137 --> 00:06:49,142 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. 17 00:06:52,627 --> 00:07:20,380 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. 18 00:07:21,070 --> 00:07:45,521 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. 19 00:07:51,791 --> 00:08:23,260 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. 20 00:08:24,070 --> 00:08:49,229 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. 21 00:08:49,285 --> 00:09:39,149 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. 22 00:09:41,794 --> 00:10:20,714 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. 23 00:10:21,690 --> 00:10:35,116 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. 24 00:10:40,255 --> 00:10:42,880 How does the fungus kill you? 25 00:10:43,920 --> 00:11:11,274 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. 26 00:11:11,670 --> 00:11:47,589 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. 27 00:11:48,420 --> 00:11:55,966 Although we currently understand the conditions and the chemical background of this poisonous fungus, there still remains no curative treatment available. 28 00:11:56,174 --> 00:11:57,938 So, why did I pick this story today? 29 00:11:59,090 --> 00:12:12,173 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. 30 00:12:14,516 --> 00:12:34,361 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. 31 00:12:39,563 --> 00:13:13,248 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. 32 00:13:14,340 --> 00:13:46,230 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. 33 00:13:46,770 --> 00:14:25,714 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'. 34 00:14:26,095 --> 00:14:56,260 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.