Mushroom Poisoning: A Case Series With a Literature Review of Cases in Asia Region (original) (raw)
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Mushroom poisoning: retrospective analysis of 294 cases
Clinics, 2010
were investigated. RESULTS: Of 294 patients between the ages of 3 and 72 (28.97 ± 19.32), 173 were female, 121 were male and 90 were under the age of 16 years. One hundred seventy-three patients (58.8%) had consumed the mushrooms in the early summer. The onset of mushroom toxicity symptoms was divided into early (within 6 h after ingestion) and delayed (6 h to 20 d). Two hundred eightyeight patients (97.9%) and six (2.1%) patients had early and delayed toxicity symptoms, respectively. The onset of symptoms was within two hours for 101 patients (34.3%). The most common first-noticed symptoms were in the gastrointestinal system. The patients were discharged within one to ten days. Three patients suffering from poisoning caused by wild mushrooms died from fulminant hepatic failure. CONCLUSION: Education of the public about the consumption of mushrooms and education of health personnel working in health centers regarding early treatment and transfer to hospitals with appropriate facilities are important for decreasing the mortality.
Mushroom poisoning: A proposed new clinical classification
Mushroom poisoning is a significant and increasing form of toxin-induced-disease. Existing classifications of mushroom poisoning do not include more recently described new syndromes of mushroom poisoning and this can impede the diagnostic process. We reviewed the literature on mushroom poisoning, concentrating on the period since the current major classification published in 1994, to identify all new syndromes of poisoning and organise them into a new integrated classification, supported by a new diagnostic algorithm. New syndromes were eligible for inclusion if there was sufficient detail about both causation and clinical descriptions. Criteria included: identity of mushrooms, clinical profile, epidemiology, and the distinctive features of poisoning in comparison with previously documented syndromes. We propose 6 major groups based on key clinical features relevant in distinguishing between poisoning syndromes. Some clinical features, notably gastrointestinal symptoms, are common to many mushroom poisoning syndromes. Group 1-Cytotoxic mushroom poisoning. Syndromes with specific major internal organ pathology: (Subgroup 1.1; Primary hepatotoxicity); 1A, primary hepatotoxicity (amatoxins); (Subgroup 1.2; Primary nephrotoxicity); 1B, early primary nephrotoxicity (amino hexadienoic acid; AHDA); 1C, delayed primary nephrotoxicity (orellanines). Group 2-Neurotoxic mushroom poisoning. Syndromes with primary neurotoxicity: 2A, hallucinogenic mushrooms (psilocybins and related toxins); 2B, autonomic-toxicity mushrooms (muscarines); 2C, CNS-toxicity mushrooms (ibotenic acid/muscimol); 2D, morel neurologic syndrome (Morchella spp.). Group 3-Myotoxic mushroom poisoning. Syndromes with rhabdomyolysis as the primary feature: 3A, rapid onset (Russula spp.); 3B, delayed onset (Tricholoma spp.). Group 4-Metabolic, endocrine and related toxicity mushroom poisoning. Syndromes with a variety of clinical presentations affecting metabolic and/or endocrine processes: 4A, GABA-blocking mushroom poisoning (gyromitrins); 4B, disulfiram-like (coprines); 4C, polyporic mushroom poisoning (polyporic acid); 4D, trichothecene mushroom poisoning (Podostroma spp.); 4E, hypoglycaemic mushroom poisoning (Trogia venenata); 4F, hyperprocalcitoninemia mushroom poisoning (Boletus satanas); 4G, pancytopenic mushroom poisoning (Ganoderma neojaponicum). Group 5-Gastrointestinal irritant mushroom poisoning. This group includes a wide variety of mushrooms that cause gastrointestinal effects without causing other clinically significant effects. Group 6-Miscellaneous adverse reactions to mushrooms. Syndromes which do not fit within the previous 5 groups: 6A, Shiitake mushroom dermatitis; 6B, erythromelagic mushrooms (Clitocybe acromelagia); 6C, Paxillus syndrome (Paxillus involutus); 6D, encephalopathy syndrome (Pleurocybella porrigens).
Mushroom poisoning in Hong Kong: a ten-year review
Hong Kong medical journal = Xianggang yi xue za zhi, 2016
Mushroom poisoning is a cause of major mortality and morbidity all over the world. Although Hong Kong people consume a lot of mushrooms, there are only a few clinical studies and reviews of local mushroom poisoning. This study aimed to review the clinical characteristics, source, and outcome of mushroom poisoning incidences in Hong Kong. This descriptive case series review was conducted by the Hong Kong Poison Information Centre and involved all cases of mushroom poisoning reported to the Centre from 1 July 2005 to 30 June 2015. Overall, 67 cases of mushroom poisoning were reported. Of these, 60 (90%) cases presented with gastrointestinal symptoms of vomiting, diarrhoea, and abdominal pain. Gastrointestinal symptoms were early onset (<6 hours post-ingestion) and not severe in 53 patients and all recovered after symptomatic treatment and a short duration of hospital care. Gastrointestinal symptoms, however, were of late onset (≥6 hours post-ingestion) in seven patients; these were...
Clinical, Laboratory and Prognosis Evaluations of Our Mushroom Poisoning Cases
Turkish Nephrology Dialysis Transplantation, 2013
OBJECTıVE: Mushroom poisoning may cause diverse clinical presentations ranging from mild gastrointestinal symptoms to fulminant hepatic failure requiring liver transplantation. It may lead to high mortality if not intervened. Toxic wild mushrooms usually grow up in spring and autumn and poisoning by these mushrooms occur mostly in these seasons. The aim of this study was to evaluate demographics, clinical features and prognosis in a large mushroom poisoning case series. maTERıal and mETHOdS: In this study, the demographics, clinical and laboratory findings, treatment methods and prognosis of 84 mushroom poisoning cases were evaluated retrospectively from their medical records. RESulTS: The mean age of the 84 cases (52 women, 32 men) was 39.8 ± 13.4 years. The main complaints upon admission were recorded as nausea-vomiting (80%), diarrhea (64%), abdominal pain (40%), and dizziness (20%). Twenty-five patients were applied hemoperfusion due to renal and hepatic failure. A case died of renal and hepatic failure. The mean of hospitalization was 6.3 ± 5.6 days. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), INR, and urea values had decreased significantly at the time of hospital discharge compared to baseline values (P < 0.001); however, no statistically significant difference existed between baseline and discharge creatinine levels (P > 0.05). COnCluSıOn: In our study, it was observed that early hemoperfusion provided better prognosis by enhancing the efficacy of the treatment. However, the best method to reduce the mortality is to enlighten the community about the risks of mushroom poisonings.
Eurasian Journal of Emergency Medicine, 2019
Aim: To evaluate differences between cultivated and wild mushroom poisoning in terms of clinical characteristics, laboratory findings, and complications. We also aimed to determine the differences among patients in regard to presence of complications. Materials and Methods: We evaluated adults who were diagnosed with mushroom poisoning at Konya Training and Research Hospital in a 4-year period between January 2014 and December 2017. The following characteristics of patients were recorded: Age, sex, complaints, time until hospital admittance, time until symptom onset, mushroom source, any interventions until patient arrived to the hospital, laboratory findings, complications like acute renal failure, neurotoxicity, rhabdomyolysis, cardiotoxicity and mortality, length of stay (LoS) at hospital, and patient discharge status. All analyses were performed on SPSS v21. Kolmogorov-Smirnov test was used to determine normality of distribution. Continuous variables were analyzed with the Mann-Whitney U test and described as median (minimummaximum). Categorical variables were analyzed with chi-square test and described as frequency (percentage). The relationships between continuous variables were determined by calculating Spearman correlation coefficients. Results: We included 168 patients (79 males and 89 females) in our study. The mean age was 46.66±18.66 years. The cause of poisoning was cultivated mushrooms for 57 (33.9%) patients and wild mushrooms for 111 (66.1%) patients. It was found that patients in the wild mushroom group were older than the patients in the cultivated mushroom group (p=0.006). Cultivated mushrooms were largely consumed by patients who live in metropolitan areas (p<0.001). Patients who consumed wild mushrooms had higher troponin levels (p=0.017), lower base excess values (0.032) and longer LoS at hospital (p=0.029). Although the sociodemographic studies of mushroom poisoning have been made numerously, this is the first study to draw attention to fact that it may also occur with cultured fungi. Conclusion: Due to the climatic conditions in the area where our study has been conducted, frequent referrals to our institution occur with mushroom poisoning particularly in spring season. However, even in cultivated mushrooms, which are thought to be harmless, poisoning cases may also be observed that are usually seen with the wild fungi. Even in cases of cultured mushroom poisoning, symptoms may develop early and more serious complications may arise.