Mortality Cases of Mushroom Poisoning with Russula subnigricans

Abstract

Mushroom poisoning is increasing worldwide, as well as the incidence of fatal mushroom poisoning. Several new syndromes associated with mushroom poisoning have been described in the literature. Notably, 1 of the newly identified mushroom poisonings is Russula subnigricans poisoning. R subnigricans can be classified as causing a delayed-onset rhabdomyolytic syndrome as patients with this severe poisoning present with severe rhabdomyolysis, acute kidney injury, and cardiomyopathy. However, there are only a few reports on the toxicity of R subnigricans. We recently treated 6 patients with R subnigricans mushroom poisoning, of whom 2 died. The 2 patients showed severe rhabdomyolysis, metabolic acidosis, acute renal failure, electrolyte imbalance, and irreversible shock, which caused their deaths. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown origin. In addition, in cases of mushroom poisoning with severe rhabdomyolysis, R subnigricans poisoning should be promptly identified.

Mushroom poisoning with cardiogenic shock caused by Russula subnigricans successfully treated with mechanical circulatory support devices: a case report

“…Previous reports on patients with cardiac dysfunction due to mushroom poisoning did not fully examine their pathophysiology. 1 , 3 , 4 In the present case, the cardiac function fully recovered, with no pathological inflammation in the endomyocardial biopsy and no evidence of myocardial damage on cardiac MRI. This indicates that R. subnigricans poisoning has an indirect influence on cardiac function, probably due to free radicals, cytokines, or haemodynamic stress.…”

“…In severe cases, patients develop rhabdomyolysis, accompanied by acute renal failure and electrolyte disturbances, finally leading to death. 2 , 3 Furthermore, cardiac disturbances including abnormal changes in electrocardiograms and systolic dysfunction, ventricular arrhythmia, and haemodynamic collapse have also been documented. 1 , 3 , 4 The mortality rate due to R. Subnigricans mushroom poisoning has been reported to be about 50%.…”

“… 2 , 3 Furthermore, cardiac disturbances including abnormal changes in electrocardiograms and systolic dysfunction, ventricular arrhythmia, and haemodynamic collapse have also been documented. 1 , 3 , 4 The mortality rate due to R. Subnigricans mushroom poisoning has been reported to be about 50%. 5 , 6 Due to the fulminant progression and high fatality rate, the mechanisms of severe cardiac dysfunction have not been fully elucidated.…”