Wild mushroom poisonings in the Middle Black Sea region in Turkey: Analyses of 6 years

Abstract

<jats:p> Wild mushroom poisoning (MP) is an important medical emergency that may have serious clinical outcome. The aim of this study was to evaluate the demographic and clinical features of patients with wild MP. This study was designed retrospectively by examining files of the patients with wild MP who were admitted to Ondokuz Mayis University Emergency Department, between January 2002 and December 2007. Patients ≥16 years of age were included in the study. A total of 317 patients poisoned by wild mushrooms (mean age, 42.0 ± 16.3 years; 67.5% female) were studied. All poisonings were accidental, i.e. consumption of wild mushrooms collected from open fields and woodlands or purchased from local bazaars. The common symptoms and complaints on admission were nausea (86.8%) and vomiting (79.8%). The poisoning latent phase in most cases was &lt;6 hours (86.8%). Most of the poisonings occurred in autumn (59.6%). Three patients died in the hospital due to acute liver failure and complications. The duration of hospitalization was a median 3 days (range: 1—12 days). The public should be informed about the probable hazards of wild mushroom ingestion. </jats:p>

Mycetism: A Review of the Recent Literature

“…Yardan reported on 317 cases of mycetism in Turkey, without delineating which mushrooms produced toxicity, and found that common symptoms include nausea (86.6 %), vomiting (79.8 %) and diarrhea (21.1 %). Nine of these patients developed moderate to severe acute hepatic failure, with 2/9 patients having a latent phase of <6 h and the remaining 7/9 patients having a latent phase of >6 h. Thus, 22 % of patients who eventually developed hepatic failure had a latent phase of <6 h [6]. Similarly, Syed reported on three patients developing severe mushroom-induced hepatitis; 1/3 (33 %) had initial symptoms within <6 h of ingestion [15].…”

“…Approximately 100 of the known species of mushrooms are poisonous to humans, with new toxic species continually being identified [2,6,7]. Some mushrooms initially classified as edible have recently been reclassified as toxic such as Tricholoma equestre (Yellow Trich or Yellow Knight) [8].…”

“…The incidence of ingesting wild, toxic mushrooms is increasingly reported [8,21,22]. Worldwide, hundreds of mushroom poisonings are fatal each year [6,8,23,24]. Most fatalities are secondary to Amanita phalloides ingestions [8,9,12,23].…”

“…Generally, most toxic mushrooms produce some gastrointestinal (GI) distress and commonly GI symptoms are the first symptoms reported. The diagnostic and prognostic value of GI symptoms are limited [6,7,11,15]. In the past, some have promoted reliance on an initial time to development of GI symptoms to predict prognosis.…”

“…Interestingly, if A. phalloides ingestion is known, or strongly suspected, to have occurred and diarrhea develops in <8 h, the prognosis is poorer [25]. Conversely, GI symptoms occurring >6 h after ingestion remain concerning for a possible serious clinical course and possible fatality [3,6,11,12,27].…”