目前对真菌中毒还处于研究阶段，了解很不够，已知一种真菌可有几种毒素，而不同种真菌又可有相同毒素，所以真菌性食物中毒时往往出现相似的症状，一般来说，急性真菌性食物中毒潜伏期短，先有胃肠道症状，如上腹不适，恶心，呕吐，腹胀，腹痛，厌食，偶有腹泻等（镰刀霉菌中毒较突出），以后依各种真菌毒素的不同作用，发生肝，肾，神经，血液等系统的损害，出现相应症状，如肝脏肿大，压痛，肝功异常，出现黄疸（常见于黄曲霉菌及岛青霉菌中毒），蛋白尿，血尿，甚至尿少，尿闭等（纯绿青霉菌中毒易发生），有些真菌（如黑色葡萄穗状霉菌，岛青霉菌）毒素引起中性粒细胞减少或缺乏，血小板减少发生出血，有些真菌（如棒曲霉菌，米曲霉菌）中毒易发生神经系症状，而有头晕，头痛，迟钝，躁动，运动失调，甚至惊厥，昏迷，麻痹等，患者多死于肝，肾功能衰竭或中枢神经麻痹，病死率可高达40％～70％，慢性真菌性食物中毒除引起肝，肾功能及血液细胞损害外，有些种真菌可以引起癌症。
曾经报道几种真菌性食物中毒如下：
1、黄曲霉毒素中毒：主要是黄曲霉菌，还有一些其他曲霉菌和青霉菌含黄曲霉毒素，这些真菌主要寄生于花生，玉米，大米，小麦等谷物及油料，急性中毒主要产生肝，肾损害，食欲低下，黄疸，1周左右死亡，慢性中毒动物试验可致成肝癌，肾癌。
2、黄变米中毒：主要见于大米，也可发生在小麦和玉米，特点是米变黄色，由青霉菌（毒青霉，桔青霉，岛青霉等菌）引起，急性中毒表现为神经麻痹，呼吸障碍，惊厥等症状，可因呼吸麻痹死亡，慢性中毒发生溶血性贫血，并可致癌。
3、灰变米中毒：米外观为灰褐色，是由半裸镰刀霉菌引起，主要表现为胃肠道症状。
4, Fumonisins poisoning:Wheat turns red, with an acute poisoning incubation period of 10 minutes to 36 hours, with symptoms of nausea, vomiting, dizziness, etc., which disappear quickly.
5, Moldy potato dreg powder poisoning:Caused by aspergillus flavus, penicillium citrinum, aspergillus niger, and trichoderma, with symptoms of nausea, vomiting, loss of appetite, flushed face, bleeding spots on the skin, low fever, abdominal distension, constipation, dizziness, weakness, and disappearance of reflexes. Finally, the pupils dilate, the heart rate slows, and death occurs due to respiratory and circulatory failure.
6, Stinking rice flour poisoning:Occurring in all provinces in Northeast China (moldy corn flour poisoning occurs in Northwest China), it is currently believed that it may be caused by the contamination of toxic fungi (fusarium and penicillium). The symptoms of poisoning include vomiting, diarrhea, abdominal pain, dizziness, headache, lack of energy, with coffee-colored vomit and mucus or bloody stools. After 2 to 3 days, liver enlargement, jaundice, and proteinuria appear. In severe cases, there are excitement, convulsions, coma, worsening jaundice, systemic bleeding, a decrease in blood pressure, and liver and kidney failure leading to death.
7, Moldy corn poisoning:Caused by fusarium and penicillium, mainly manifested by gastrointestinal symptoms.
8, Leukopenia caused by food poisoning:First seen in the Soviet Union, caused by fusarium, with symptoms of nausea, vomiting, increased respiration, and in severe cases, convulsions or heart failure leading to death. In mild cases, after a 3 to 8-day stationary period, they enter a deterioration phase, with a decrease in white blood cells, a decrease in neutrophils, and the appearance of gastrointestinal ulcers and bleeding.
9, Black grape cluster mold poisoning:After poisoning, there is first drooling, congestion of the mucous membranes, and then enter a stationary phase, with a decrease in white blood cells, followed by an increase in body temperature, diarrhea, dehydration, necrosis and bleeding of the mucous membranes. In severe cases, neurological symptoms appear quickly, and death can occur within 72 hours.
10, Moldy sugarcane poisoning:The main pathogens detected are fusarium moniliforme and fusarium proliferatum, whose toxins can stimulate the gastrointestinal mucosa, damage cranial nerves, with an incubation period of 15 minutes to 7 hours, most of which occur within 2 to 5 hours after eating. The initial symptoms include nausea, vomiting, abdominal pain, diarrhea, sweating, followed by headache, dizziness, excitement, convulsions, coma, delirium, and aphasia. The main signs include nystagmus, upward gaze of both eyes, neck stiffness, hyperreflexia, positive pathological reflexes, normal cerebrospinal fluid routine and biochemical tests. After the acute phase, a few children may have sequelae, mainly manifested as extrapyramidal nervous system damage.
