Mushroom poisoning in children: A five-year review

Abstract

Background: Mushroom poisoning is a global problem and can be a source of major mortality and morbidity. Children can easily be exposed to inadvertent mushroom ingestion. Objectives: The aim of this study was to assess the demographic, clinical, and laboratory features of pediatric patients with mushroom poisoning. Methods: This was a retrospective and observational study of reported cases of exposure to mushroom poisoning at the Department of Pediatrics at West China Second University Hospital of Sichuan University and Wan Yuan Central Hospital between June 2011 and July 2016. The patients’ demographic, clinical, and laboratory features were evaluated. Results: Fifty-eight patients aged between 1.22 and 16.71 years old were studied; 24 patients were female (41%) and 34 were male (59%). Thirty-seven (63.79%) patients had consumed mushrooms in the summer. The most frequent complaints were nausea and vomiting (98.28%). The onset of mushroom toxicity symptoms was divided to early-onset (< 6 hours after ingestion) and late-onset groups (6 to 24 hours). The incidence of life-threatening cases was higher in the late-onset group than that of the early-onset group (88.9% versus 12.2%, P < 0.0001). Three patients with mushroom poisoning died due to fatal hepatic failure, and one patient died due to cardiac arrest (myocardial toxicity). The value of White Blood cell Count (WBC), total bilirubin, and number of involved organs were significantly higher in the group who died than that of the survived group (14.9 × 109 versus 11.8 × 109, P = 0.002; 125 versus 8.5, P = 0.0001; 4.5 versus 1, P < 0.0001, respectively). The level of hemoglobin was lower in the group who died than those who survived (111 versus 132, P = 0.001). Conclusions: Parents and children must be taught to avoid eating unknown mushrooms. Life-threatening poisoning cases are often encountered in patients with late-onset mushroom toxicity symptoms. When children present nausea and vomiting during the rainy season, doctors should maintain keen vigilance towards mushroom poisoning. Acute liver failure is the main cause of death, yet myocardial toxicity should also be considered.