Poisoning with poisonous mushrooms

Poisoning with poisonous mushrooms is common everywhere. Among the 2,500 varieties of fungi native to Europe, about 200 are potentially poisonous: approximately 10,000 cases of poisoning are recorded annually. In Russia, poisoning is caused by 20-25 types of poisonous mushrooms. The most poisonous are the pale toadstool and fly agaric. Toxic to humans are also lines, some types of false opyat.

The pale toadstool is yellow, green, and white. The last two varieties are particularly poisonous.

Poisoning with pale toadstool has a pronounced seasonality - from mid-July to mid-October. The curve peaks in August.

The mushroom cap contains more toxic substances than the stem. The toxic substances of the pale toadstool are not destroyed by heat treatment and can persist for many years. The toxic substances isolated from the pale toadstool are cyclopeptides and are mainly represented by two groups of poisons-phallotoxins and amanitotoxins. Almost one mushroom is enough to cause fatal poisoning of an adult. Lethality-more than 50%.

Toxins are rapidly absorbed in the gastrointestinal tract, deposited in the liver (57%), and in the kidneys (2.7%). Phallotoxins act quickly (6-8 hours), but are less toxic, since they are poorly absorbed in the intestine and are thermolabile. Amanitotoxins act more slowly (28-46 h), but their toxicity is 20 times higher than that of phallotoxins.

Pale toadstool toxins have mainly hepatotoxic, as well as nephrotoxic and enterotoxic effects. It should be noted that very small amounts of amanitotoxins are found in all edible mushrooms, so it is possible to poison them when ingested in a large dose (

Clinical picture. The latency period is from 6 to 30 hours. There was no obvious relationship between the duration of the latent period and the severity of poisoning. The period of acute gastroenteritis lasts from 1 to 8 days. Clinical manifestations begin suddenly: malaise, weakness, indomitable vomiting, diarrhea. The stool is frequent, watery. Gradually increase weakness, violations of the water-electrolyte balance. On the 2nd-3rd day, signs of toxic hepatopathy develop (enlarged liver, jaundice, hemorrhagic diathesis), nephropathy, hepatic-renal failure (hepatargy, anuria, coma). Extremely severe poisoning occurs in children.

According to the severity of intoxication, they are divided into mild (20% of cases) – moderate: manifestations of gastroenteritis, mild hepatopathy; moderate (30% of cases) – severe gastroenteritis, moderate hepatopathy, mild or moderate nephropathy, and severe (50% of cases) - pronounced gastroenteritis, severe hepatopathy, nephropathy with the development of acute liver failure.

Lightning-fast forms of the course are possible, especially in children, with the development of acute liver atrophy and rapid death. The main cause of death is acute liver failure. Pathomorphological changes in the liver are manifested by the development of total necrosis of hepatocytes.

Some useful tips when collecting mushrooms:

• you only need to collect familiar types of mushrooms,
• bringing home, you need to arrange the mushrooms by type,
• if you suddenly find unfamiliar types of mushrooms, it is advisable to throw them away.

ATTENTION!

• The presence of symptoms more than 6 hours after eating mushrooms is an indication for mandatory hospitalization!
• One mushroom in a pot is enough to poison several people with food.
• Digestive disorders in children and the elderly often lead to complications, so hospitalization is mandatory for these categories of patients.
• It is better not to eat unknown mushrooms, and not to identify them from the photo, because this is often the cause of errors.

If symptoms of poisoning appear, it is necessary to wash the stomach, take the sorbent inside (activated charcoal, enterosgel, etc.), call an ambulance.
Timely medical care can improve the prognosis of poisoning.

Chief freelance specialist toxicologist of the Health Department of the Lipetsk region Krivosheeva Olga Dmitrievna