Management of confirmed mushroom poisoning
DOI:
https://doi.org/10.12775/JEHS.2023.13.01.029Keywords
Wild mushroom intoxication, poisoning, hepatotoxicity, Amanita PhalloidesAbstract
During the autumn season, it is common for mushroom pickers to eat poisonous mushrooms. This is due to many reasons, including the ignorance of pickers. The most common is the misidentification of inedible species as edible mushrooms. The result is poisoning, which in many cases requires hospitalization.
This paper presents a case report of toadstool poisoning by a 62-year-old female patient. In addition, other relevant publications on intoxication, diagnostic methods and treatment are reviewed. The purpose of this paper is to present the management and treatment of a case of toadstool poisoning.
The effects of mushroom poisoning can range from mild disorders, mainly gastrointestinal to organ failure and even death. Significant elevations of liver enzymes and prothrombin time are important in laboratory tests in cases of intoxication. Treatment most often involves specific antidotes, such as Sylimarin, Acetylcysteine. The diagnosis in most cases is made on the basis of the clinical picture and a thorough interview with the patient, and the diagnosis is established by detecting toxins in a urine test. The prognosis is better if patients with toadstool poisoning are admitted to the hospital early. It is worth noting that gastrointestinal syndromes can also result from eating raw or inadequately cooked mushrooms, and by eating them excessively or too often.
Proper diagnosis and treatment of mushroom poisoning can save lives. It is very important to raise public awareness of mushroom poisoning, as well as early detection of potential signs of intoxication. Cooperation with the poison center and mycologists is very important, especially in high-risk cases.
References
Berger K.J., Guss D.A. Mycotoxins revisited: Part I. J. Emerg. Med. 2005;28:53–62. doi: 10.1016/j.jemermed.2004.08.013.
Schenk-Jaeger K.M., Rauber-Lüthy C., Bodmer M., Kupferschmidt H., Kullak-Ublick G.A., Ceschi A. Mushroom poisoning: A study on circumstances of exposure and patterns of toxicity. Eur. J. Int. Med. 2012;23:e85–e91. doi: 10.1016/j.ejim.2012.03.014.
Schmutz M., Carron P.N., Yersin B., Trueb L. Mushroom poisoning: A retrospective study concerning 11-years of admissions in a Swiss Emergency Department. Intern. Emerg. Med. 2018;13:59–67. doi: 10.1007/s11739-016-1585-5.
Eren S.H., Demirel Y., Ugurlu S., Korkmaz I., Aktas C., Guven F.M. Mushroom poisoning: Retrospective analysis of 294 cases. Clinics. 2010;65:491–496. doi: 10.1590/S1807-59322010000500006.
Lin Y., Wang T. Mushroom poisoning. Ann. Disaster Med. 2004;3:S8–S11.
Ukwuru M.U., Muritala A., Eze L.U. Edible and non-edible wild mushrooms: Nutrition, toxicity and strategies for recognition. [(accessed on 1 October 2018)];J. Clin. Nutr. Metab. 2018
U.S. Food & Drug Administration, Center for Food Safety & Applied Nutrition Mushroom Toxins. [(accessed on 1 October 2018)];
Diaz J.H. Syndromic diagnosis and management of confirmed mushroom poisonings. Crit. Care Med. 2005;33:427–436. doi: 10.1097/01.CCM.0000153531.69448.49.
Tox Info Suisse: Annual Report 2016. [(accessed on 1 May 2018)];
Pajoumand A., Shadnia S., Efricheh H., Mandegary A., Hassanian-Moghadam H., Abdollahi M. A retro-spective study of mushroom poisoning in Iran. Hum. Exp. Toxicol. 2005;24:609–613. doi: 10.1191/0960327105ht572oa.
Unluoglu I., Tayfur M. Mushroom poisoning: An analysis of the data between 1996 and 2000. Eur. J. Emerg. Med. 2003;10:23–26. doi: 10.1097/00063110-200303000-00007.
Block SS, Stephens RL, Barreto A, Murrill WA. Chemical identification of the Amanita toxin in mushrooms. Science 1955;121:505–6. 10.1126/science.121.3145.505
Bryngil J. Amanita phalloides. Clinical Toxicology Review. 1999;21:191–198.
2. Enjalbert F, Rapior S, Nouguier-Soulé J, Guillon S, Amouroux N, Cabot C. Treatment of amatoxin poisoning: 20-Year retrospective analysis. Journal of Toxicology. 2002;40(6):715–757.
1. Karlson-Stiber C, Persson H. Cytotoxic fungi—an overview. Toxicon. 2003;42(4):339–349.
Vetter J. Toxins of Amanita phalloides . Toxicon. 1998;36(1):13–24.
Köppel C. Clinical symptomatology and management of mushroom poisoning. Toxicon. 1993;31(12):1513–1540.
Dart R. Medical Toxicology. Philadelphia, Pa, USA: Williams & Wilkins; 2004. Mushrooms; pp. 1719–1735.
Leist M, Gantner F, Naumann H, et al. Tumor necrosis factor-induced apoptosis during the poisoning of mice with hepatotoxins. Gastroenterology. 1997;112(3):923–934.
Manoguerra A. Amanita phalloides—type mushroom poisoning. Bulletin of San Diego Regional Poison Control Center. 1982;6:p. 1.
Derenzini M, Betts CM, Busi C, Fiume L. Ultrastructural changes in β-cells of pancreatic islets in α-amanitin-poisoned mice. Virchows Archiv B. 1978;28(1):13–20.
Persson HE, Sjöberg GK, Haines JA, Pronczuk de Garbino J. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol. 1998;36(3):205–213.
Faybik P, Hetz H, Baker A, et al. Extracorporeal albumin dialysis in patients with Amanita phalloides poisoning. Liver Int. 2003;23(Suppl 3):28–33.
Floersheim GL, Weber O, Tschumi P, Ulbrich M. Clinical death-cap (Amanita phalloides) poisoning: prognostic factors and therapeutic measures. Analysis of 205 cases [In German] Schweiz Med Wochenschr. 1982 Aug 21;112(34):1164–1177.
Olson KR, Pond SM, Seward J, Healey K, Woo OF, Becker CE. Amanita phalloides-type mushroom poisoning. West J Med 1982;137:282–9.
Ergüven M, Çakı S, Deveci M. Mantar zehirlenmesi: 28 vakanın değerlendirilmesi [Mushroom poisoning: Evaluation of 28 cases] Çocuk Sağlığı ve Hastalıkları Dergisi. 2004;47:249–253.
Petekkaya S, Börk T, Ayaz N, Göktürk C, Şamdancı E, Celbiş O. Fatal mushroom poisoning in Syrian refugees. Azerb Med Assoc J. 2016;1(1):30. doi: 10.5455/amaj.2016.01.010.
https://medicalxpress.com/news/2017-10-dead-sick-mushroom-poisoning-denmark.html Published: 20 Oct 2017
https://www.infomigrants.net/en/post/4339/migrants-suffer-poisoning-after-mistaking-deadly-mushroom-as-edible Published: 27 Jul 2017
Smędra A, Wochna K, Zawadzki D, Berent J. Medical error in treatment of Amanita phalloides poisoning in pre-hospital care. Scand J Trauma Resusc Emerg Med. 2022 Mar 19;30(1):20. doi: 10.1186/s13049-022-01008-2. PMID: 35305697; PMCID: PMC8933750.
Keller SA, Klukowska-Rötzler J, Schenk-Jaeger KM, Kupferschmidt H, Exadaktylos AK, Lehmann B, Liakoni E. Mushroom Poisoning-A 17 Year Retrospective Study at a Level I University Emergency Department in Switzerland. Int J Environ Res Public Health. 2018 Dec 14;15(12):2855. doi: 10.3390/ijerph15122855.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Kinga Brzuszkiewicz, Kinga Pożarowska, Gracjan Rudziński, Borys Łozowski, Natalia Kusak, Arkadiusz Grunwald, Michał Tchórz
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 450
Number of citations: 0