Mushroom Poisoning with Symptoms of Pantherina Syndrome: A Case Report

Yıl 2016, Cilt: 7 Sayı: 4, 67 - 69, 01.10.2016

Çağdaş Yıldırım Gülhan Kurtoğlu Çelik Güllü Ercan Haydar Gül Pamukçu Günaydın Yavuz Otal Ayhan Özhasenekler

Öz

Introduction: The emergency department is the most common site of presentation for patients suffering from acute mushroom poisoning; therefore, emergency physicians should be familiar with it. We present a case of mushroom poisoning that was initially misdiagnosed as a cerebrovascular event.Case Report: A 59-year-old male patient was referred to our emergency service from another hospital with the presumptive diagnosis of a cerebrovascular event. He had presented to the other hospital with complaints of a decrease in consciousness and hallucinations that started 2 h ago. Upon presentation he was unconscious. Family members stated that 30 min before his symptoms started, he had eaten mushrooms that he had collected himself from nature. Active charcoal was administered after gastric lavage. Diazepam was given for agitations. Fifteen hours after the ingestion of mushrooms, the patient was fully conscious. He was monitored for 36 hours and was discharged uneventfully.Conclusion: Pantherina syndrome is a type of mushroom poisoning that has been classified as glutaminergic neurotoxic syndrome with early onset. Treatment is mainly supportive and should be guided by the patient’s symptoms rather than by attempts at mushroom identification. Elimination of the mushroom from the gastrointestinal tract by gastric lavage and the administration of activated charcoal is recommended. Generally, the symptoms are mild and require no further treatment. Emergency physicians should consider mushroom poisoning in the evaluation of patients with acute onset delirium who may be intoxicated by natural substances

Anahtar Kelimeler

Amanita pantherina, mushroom poisoning, pantherina syndrome

Kaynakça

• Berger KJ, Guss DA. Mycotoxins revisited: Part I. J Emerg Med 2005; 28: 53-62. [CrossRef]
• Eren SH, Demirel Y, Uğurlu S, Korkmaz I, Aktaş C, Güven FM. Mushroom poisoning: retrospective analysis of 294 cases. Clinics (Sao Paulo) 2010; 65: 491-6. [CrossRef]
• Yardan T, Baydin A, Eden AO, Akdemir HU, Aygun D, Acar E et al. Wild mushroom poisonings in the Middle Black Sea region in Turkey: analy- ses of 6 years. Hum Exp Toxicolo 2010; 29: 767-71. [CrossRef]
• Michelot D, Melendez-Howel LM. Amanita muscaria: chemistry, biol- ogy, toxicology, and ethnomycology. Mycol Res 2003; 107: 131-46. [CrossRef]
• Satora L, Pach D, Ciszowski K, Winnik L. Panther cap Amanita pantherina poisoning case report and review. Toxicon 2006; 47: 605-7. [CrossRef]
• Diaz JH. Syndromic diagnosis and management of confirmed mush- room poisonings. Crit Care Med 2005; 33: 427-36. [CrossRef]
• Berger KJ, Guss DA. Mycotoxins revisited: Part II. J Emerg Med 2005; 28: 175-83. [CrossRef]
• Vendramin A, Brvar M. Amanita muscaria and Amanita pantherina poi- soning: two syndromes. Toxicon 2014; 90: 269-72. [CrossRef]