Wild mushroom exposures in Kansas, 2013–2018

Sam Wagner, S. Thornton, L. Oller, Michelle L Wilson, M. Hudson
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Abstract

Abstract Background Mushrooms exposures are uncommon, difficult to characterize, and occasionally cause serious morbidity and mortality. We describe mushroom exposures reported to the Kansas Poison Control Center (KSPCC). Methods We queried the KSPCC database for all mushroom exposures from 1 January 2013 to 31 December 2018. We abstracted age, sex, exposure date, reason, management site, laboratory values, medical outcome, GI symptoms, interventions, mycologist consultation, presence of mushroom picture, and identification of the mushroom. Results We identified 441 cases. Typical cases were young children with exploratory ingestion in summer managed at home (279) with no clinical effect (257). Vomiting or diarrhea occurred in 135 cases. Treatments included either no intervention or PO liquids (304), IV fluids (76), anti-emetics (59), or N-acetylcysteine (5). AST was normal in 52 of 55 cases. CPK was high in 3 of 7 patients. Care included hospital admission (56) including ICU in nine. There were no deaths. Most frequently identified were Chlorophyllum (29) and Psilocybe sp. (13). Conclusions Mushroom exposures reported to KPCC were most common in summer months and typically involved unintentional exposures in young children. Vomiting and diarrhea occurred in approximately one-third of cases. Morbidity was minimal. No deaths occurred. In most cases, the mushroom was never identified.
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2013-2018年,堪萨斯州野生蘑菇曝光
蘑菇暴露是不常见的,难以表征,偶尔会引起严重的发病率和死亡率。我们描述蘑菇暴露报告给堪萨斯毒物控制中心(KSPCC)。方法:我们查询了KSPCC数据库中2013年1月1日至2018年12月31日的所有蘑菇暴露。我们提取了年龄、性别、暴露日期、原因、管理地点、实验室值、医疗结果、胃肠道症状、干预措施、真菌学家咨询、蘑菇图片的存在和蘑菇的鉴定。结果共确诊441例。典型病例为幼儿夏季探索性食入(279例),在家管理,无临床效果(257例)。呕吐、腹泻135例。治疗包括不干预或PO液体(304例)、静脉输液(76例)、止吐剂(59例)或n -乙酰半胱氨酸(5例)。55例中有52例AST正常。7例患者中有3例CPK较高。治疗包括住院56例,其中ICU 9例。没有人员死亡。最常见的是叶绿素(29)和裸盖菇(13)。结论KPCC报告的蘑菇暴露最常见于夏季,通常涉及幼儿的无意暴露。大约三分之一的病例出现呕吐和腹泻。发病率极低。没有人员死亡。在大多数情况下,蘑菇从未被识别出来。
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