Mushroom Poisoning Cases from an Emergency Department in Central Anatolia: Comparison and Evaluation of Wild and Cultivated Mushroom Poisoning

Abstract

Aim:To evaluate differences between cultivated and wild mushroom poisoning in terms of clinical characteristics, laboratory findings, and complications. We also aimed to determine the differences among patients in regard to presence of complications.Materials and Methods:We evaluated adults who were diagnosed with mushroom poisoning at Konya Training and Research Hospital in a 4-year period between January 2014 and December 2017. The following characteristics of patients were recorded: Age, sex, complaints, time until hospital admittance, time until symptom onset, mushroom source, any interventions until patient arrived to the hospital, laboratory findings, complications like acute renal failure, neurotoxicity, rhabdomyolysis, cardiotoxicity and mortality, length of stay (LoS) at hospital, and patient discharge status. All analyses were performed on SPSS v21. Kolmogorov-Smirnov test was used to determine normality of distribution. Continuous variables were analyzed with the Mann-Whitney U test and described as median (minimummaximum). Categorical variables were analyzed with chi-square test and described as frequency (percentage). The relationships between continuous variables were determined by calculating Spearman correlation coefficients.Results:We included 168 patients (79 males and 89 females) in our study. The mean age was 46.66±18.66 years. The cause of poisoning was cultivated mushrooms for 57 (33.9%) patients and wild mushrooms for 111 (66.1%) patients. It was found that patients in the wild mushroom group were older than the patients in the cultivated mushroom group (p=0.006). Cultivated mushrooms were largely consumed by patients who live in metropolitan areas (p<0.001). Patients who consumed wild mushrooms had higher troponin levels (p=0.017), lower base excess values (0.032) and longer LoS at hospital (p=0.029). Although the sociodemographic studies of mushroom poisoning have been made numerously, this is the first study to draw attention to fact that it may also occur with cultured fungi.Conclusion:Due to the climatic conditions in the area where our study has been conducted, frequent referrals to our institution occur with mushroom poisoning particularly in spring season. However, even in cultivated mushrooms, which are thought to be harmless, poisoning cases may also be observed that are usually seen with the wild fungi. Even in cases of cultured mushroom poisoning, symptoms may develop early and more serious complications may arise.

Keywords

• Cultivated mushroom poisoning
• wild mushroom poisoning
• laboratory findings
• clinical characteristics
• complication