Skip to main content
SpringerLink
Log in

Mushroom poisoning: a retrospective study concerning 11-years of admissions in a Swiss Emergency Department

  • EM - ORIGINAL
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

Wild mushroom intoxication is an unusual cause of toxic ingestion in Europe. A great diversity of clinical symptoms may arise depending on the variety of wild mushrooms ingested. These initial symptoms are often non-specific, with frequent gastrointestinal symptoms, and have no direct correlation with the outcome. Therefore, management of mushroom poisoning and risk evaluation are a challenge for emergency clinicians. We retrospectively reviewed all cases of mushroom poisoning identified in the ED database spanning 11 years. Demographic and clinical data, time from consumption to symptoms, type of mushrooms, the number of patients presenting at the same time, treatment(s) provided, length of stay, discharge diagnosis, in-hospital mortality, and serious complications were evaluated. We identify 87 cases of mushroom poisoning. The most common symptoms are nausea and vomiting (71 cases, 82%), followed by diarrhea (68%), syncope (10%), abdominal pain (8%), and hallucinations (7%). Sixty-four patients (74%) exhibited early symptoms (appearance <6 h after ingestion) and 23 (26%) late symptoms (appearance >6 h after ingestion). Eleven patients (13%) required hospitalization over 24 h. Patients with late symptoms tended to have longer in-hospital lengths of stay. Only one patient had Amanita phalloides intoxication, with a favorable outcome. Thirty-eight patients (44%) were involved in cluster presentations. Mushroom poisoning is an unusual but potentially severe form of intoxication. Patients presenting with late-appearing symptoms (>6 h) are associated with a higher risk of A. phalloides intoxication, and therefore require specific investigation and management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Schenk-Jaeger KM, Rauber-Luthy C, Bodmer M, Kupferschmidt H, Kullak-Ublick GA, Ceschi A (2012) Mushroom poisoning: a study on circumstances of exposure and patterns of toxicity. Eur J Intern Med 23(4):e85–e91. doi:10.1016/j.ejim.2012.03.014

    Article  PubMed  Google Scholar 

  2. Kupferschmidt H, Rauber-Lüthy C (2015) Vergiftung in der Schweiz. Bull Med Suisse 96:1310–1313

    Google Scholar 

  3. Ferréol J-Y (2016) Champignons cueillis et utilisés pour la consommation personnelle—contrôles effectués en 2014. http://www.vapko.ch/phocadownload/public/FR/La_Vapko/contrle%20des%20rcoltes%20prives%202014%20-%20synthse%20internet.pdf. Accessed 04 July 2016

  4. Gawlikowski T, Romek M, Satora L (2015) Edible mushroom-related poisoning: a study on circumstances of mushroom collection, transport, and storage. Hum Exp Toxicol 34(7):718–724. doi:10.1177/0960327114557901

    Article  CAS  PubMed  Google Scholar 

  5. Blackman JR (1994) Clinical approach to toxic mushroom ingestion. J Am Board Fam Pract 7(1):31–37

    CAS  PubMed  Google Scholar 

  6. Flesch F, Saviuc P (2004) Intoxications par les champignons: principaux syndromes et traitement. EMC Méd 1:70–79

    Article  Google Scholar 

  7. Trueb L, Carron PN, Saviuc P (2013) Mushroom poisoning. Rev Med Suisse 9(394):1465–1472

    CAS  PubMed  Google Scholar 

  8. Diaz JH (2005) Syndromic diagnosis and management of confirmed mushroom poisonings. Crit Care Med 33(2):427–436

    Article  PubMed  Google Scholar 

  9. Erden A, Esmeray K, Karagoz H, Karahan S, Gumuscu HH, Basak M, Cetinkaya A, Avci D, Poyrazoglu OK (2013) Acute liver failure caused by mushroom poisoning: a case report and review of the literature. Int Med Case Rep J 6:85–90. doi:10.2147/IMCRJ.S53773

    PubMed  PubMed Central  Google Scholar 

  10. Ward J, Kapadia K, Brush E, Salhanick SD (2013) Amatoxin poisoning: case reports and review of current therapies. J Emerg Med 44(1):116–121. doi:10.1016/j.jemermed.2012.02.020

    Article  PubMed  Google Scholar 

  11. Eren SH, Demirel Y, Ugurlu S, Korkmaz I, Aktas C, Guven FM (2010) Mushroom poisoning: retrospective analysis of 294 cases. Clinics 65(5):491–496. doi:10.1590/S1807-59322010000500006

    Article  PubMed  PubMed Central  Google Scholar 

  12. Comelli I, Lippi G, De Blasio A, Cervellin G (2013) Accidental mushroom poisoning mimicking stroke. A case report and literature review. Acta Bio Med Atenei Parm 84(3):229–233

    Google Scholar 

  13. Rutschmann O, Sieber R, Hugli O (2009) Recommandations de la SSMUS pour le triage dans les services d’urgences hospitaliers en Suisse. Bull Med Suisse 90(46):1789–1790

    Article  Google Scholar 

  14. Pajoumand A, Shadnia S, Efricheh H, Mandegary A, Hassanian-Moghadam H, Abdollahi M (2005) A retrospective study of mushroom poisoning in Iran. Hum Exp Toxicol 24(12):609–613

    Article  CAS  PubMed  Google Scholar 

  15. Unluoglu I, Tayfur M (2003) Mushroom poisoning: an analysis of the data between 1996 and 2000. Eur J Emerg Med 10(1):23–26. doi:10.1097/01.mej.0000057022.75699.93

    Article  CAS  PubMed  Google Scholar 

  16. Ahishali E, Boynuegri B, Ozpolat E, Surmeli H, Dolapcioglu C, Dabak R, Bahcebasi ZB, Bayramicli OU (2012) Approach to mushroom intoxication and treatment: can we decrease mortality? Clin Res Hepatol Gastroenterol 36(2):139–145. doi:10.1016/j.clinre.2011.11.004

    Article  PubMed  Google Scholar 

  17. Kintziger KW, Mulay P, Watkins S, Schauben J, Weisman R, Lewis-Younger C, Blackmore C (2011) Wild mushroom exposures in Florida, 2003–2007. Public Health Rep 126(6):844–852

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lin Y, Wang T (2004) Mushroom poisoning. Ann Disaster Med 3(Supp1):S8–S11

    Google Scholar 

  19. Cassidy N, Duggan E, Tracey JA (2011) Mushroom poisoning in Ireland: the collaboration between the National Poisons Information Centre and expert mycologists. Clin Toxicol 49(3):171–176. doi:10.3109/15563650.2011.560854

    Article  Google Scholar 

  20. Holohan TW, Humphreys CP, Johnson H, Casey PB, Tracey JA, Laffoy M, Clarke AT (2000) Sources of information for acute poisoning in accident and emergency departments in Dublin, Ireland. J Toxicol Clin Toxicol 38(1):29–36

    Article  CAS  PubMed  Google Scholar 

  21. Epis S, Matinato C, Gentili G, Varotto F, Bandi C, Sassera D (2010) Molecular detection of poisonous mushrooms in different matrices. Mycologia 102(3):747–754

    Article  CAS  PubMed  Google Scholar 

  22. Masayama A, Murakami T, Sakuma D, Ki M, Yamano T, Shimizu M (2012) Discrimination of mushrooms causing food-poisoning incidents by using DNA sequence analysis. Shokuhin Eiseigaku Zasshi J Food Hyg Soc Japan 53(5):237–242

    Article  CAS  Google Scholar 

  23. Ishihara Y, Yamaura Y (1992) Descriptive epidemiology of mushroom poisoning in Japan. Nihon eiseigaku zasshi Japanese journal of hygiene 46(6):1071–1078

    Article  CAS  PubMed  Google Scholar 

  24. Hauffe T, Mayer F, Kupferschmidt H (2013) Poisoning with Amanita mushrooms. Praxis 102(25):1507–1515. doi:10.1024/1661-8157/a001530

    Article  PubMed  Google Scholar 

  25. Letschert K, Faulstich H, Keller D, Keppler D (2006) Molecular characterization and inhibition of amanitin uptake into human hepatocytes. Toxicological sciences: an official journal of the Society of Toxicology 91(1):140–149. doi:10.1093/toxsci/kfj141

    Article  CAS  Google Scholar 

  26. Enjalbert F, Rapior S, Nouguier-Soule J, Guillon S, Amouroux N, Cabot C (2002) Treatment of amatoxin poisoning: 20-year retrospective analysis. J Toxicol Clin Toxicol 40(6):715–757

    Article  CAS  PubMed  Google Scholar 

  27. Colak S, Kandis H, Afacan MA, Erdogan MO, Gunes H, Kaya E, Akdemir HU, Saritas A (2015) Assessment of patients who presented to the emergency department with mushroom poisoning. Hum Exp Toxicol 34(7):725–731. doi:10.1177/0960327114557902

    Article  CAS  PubMed  Google Scholar 

  28. O’Grady JG, Alexander GJ, Hayllar KM, Williams R (1989) Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 97(2):439–445

    Article  PubMed  Google Scholar 

  29. Ferreira R, Romaozinho JM, Amaro P, Ferreira M, Sofia C (2011) Assessment of emergency liver transplantation criteria in acute liver failure due to Amanita phalloides. Eur J Gastroenterol Hepatol 23(12):1226–1232. doi:10.1097/MEG.0b013e32834c7b8f

    Article  PubMed  Google Scholar 

  30. Escudie L, Francoz C, Vinel JP, Moucari R, Cournot M, Paradis V, Sauvanet A, Belghiti J, Valla D, Bernuau J, Durand F (2007) Amanita phalloides poisoning: reassessment of prognostic factors and indications for emergency liver transplantation. J Hepatol 46(3):466–473. doi:10.1016/j.jhep.2006.10.013

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Emergency Department, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Maxime Schmutz, Pierre-Nicolas Carron, Bertrand Yersin & Lionel Trueb

Authors
  1. Maxime Schmutz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pierre-Nicolas Carron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bertrand Yersin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lionel Trueb
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lionel Trueb.

Ethics declarations

Conflict of interest

The Authors declare that they have no conflict of interest.

Funding

None declared.

Statement of human and animal rights

The study received approval from the Human Research Ethics Committee of the Canton of Vaud.

Informed consent

Because of the retrospective nature of this research and its anonymity, the study did not require personal information or explicit agreement of the patients.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schmutz, M., Carron, PN., Yersin, B. et al. Mushroom poisoning: a retrospective study concerning 11-years of admissions in a Swiss Emergency Department. Intern Emerg Med 13, 59–67 (2018). https://doi.org/10.1007/s11739-016-1585-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-016-1585-5

Keywords

Search

Navigation