Citation

Centers for Disease Control and Prevention, USA. MMWR Morb. Mortal. Wkly. Rep. 1974; 23(1): 4.

Copyright

(Copyright © 1974, (in public domain), Publisher U.S. Centers for Disease Control and Prevention)

DOI

unavailable

PMID

unavailable

Abstract

In November 1973, 2 20-year-old men from San Mateo County, California, became ill with severe nausea, vomiting, diarrhea, weakness, and malaise 12 hours after eating fried mushrooms that they had picked in the hills near La Honda. They received Compazine and Lomotil, and 1 man recovered 3 days later. The other was hospitalized on the fourth day of his illness with jaundice, hematemesis, and seizures. He lapsed into a coma the following day and died of toxin-induced massive hepatic necrosis despite vigorous supportive treatment. No mushrooms remained for identification; however, the incubation period and symptom complex were characteristic of poisoning by mushrooms of the cyclo-peptide group (Amonita phalloides, A. vema, and certain Galerina spj. A. phalloides caused 3 deaths in California in 1972.

(Reported by Peter Rudd, M.D., Medical Resident, Edward Ruhenstein. MD.. Attending Physician, Lisa Saami. Medical Extern, Brian Paaso, M.D., Gastroenterologe fellow. Department of Medicine. Stanford Univenitv Medical Center: Ronald R. Roberto. M.D.. Medical Epidemiologist. James Chin. M.D., State Epidemiologist, California State Department of Health, and an EIS Officer.)

Editorial Note: Symptoms of Group A cyclopeptide poisoning appear 6 to 24 hours after ingestion of mushrooms. Sharp abdominal pains are followed by violent vomiting and persistent, profuse diarrhea, which may be bloody. These symptoms tend to subside, but in 3 to 4 days the patient's condition begins to worsen with symptoms of liver, kidney, and central nervous system failure which may lead to death within a week. The fatality rate is 30% to 50%. There is no specific antidote. The late onset of symptoms makes early treatment of relatively little help. Gastric lavage might prevent further absorption of toxins. Fluid and electrolyte imbalances need to be corrected. SCOT or SGPT levels and prothrombin time should be measured immediately and monitored frequently. Hemodialysis may prove useful. Consideration should be given to treatment with experimental drugs (thioctic acid, cytochrome-C) available only from the Food and Drug Administration