Poisonous mushroom poisoning

According to statistics, out of 3 thousand mushrooms known today, only 400 species are edible, the rest are inedible and can cause severe intoxication if they enter the human body. Unfortunately, cases of poisoning by mushrooms bought in supermarkets have been increasingly recorded lately. Improper storage and preparation of mushrooms can cause serious health problems. Even edible mushrooms can be dangerous due to the accumulation of harmful substances if they are grown in ecologically unfavorable areas.

Poisoning by poisonous mushrooms most often occurs in late summer and the first half of autumn, during the harvest season, and can have serious consequences, including death.

The symptoms and severity of poisoning depend on factors such as the type and quantity of mushrooms eaten, the age of the victim, their health, and weight. The immune system is unable to cope with toxins that have entered the body, so if you feel worse, you must go to the hospital without delay. Children and the elderly tolerate poisoning the worst. Death can occur within a few hours after eating inedible mushrooms, such as the death cap or fly agaric, which results in paralysis of the nervous system, respiratory arrest, general intoxication, and liver necrosis. In order to prevent irreversible consequences, you need to take precautions in a timely manner.

ICD 10 code

Poisoning with poisonous mushrooms refers to food poisoning (abbreviated - PO), which is registered in the International Classification of Diseases and has a code according to ICD 10. This type of poisoning is specifically listed under the code AO-5, which stands for "other bacterial toxic infections."

Diseases of bacterial origin are distributed as follows:

• Microbial (mycotoxicosis, botulism, staphylococcal toxicosis, various toxic infections, including mixed types);
• Non-microbial (poisoning by poisonous mushrooms, as well as certain types of fish and fish eggs);
• Toxic infections of unknown etiology.

Food poisoning caused by eating foods with a high accumulation of toxins can cause serious complications, including failure of internal organs (particularly the liver), as well as asphyxia and cardiac arrest. Mushroom pickers should remember the possible risks when harvesting in the fall season. You need to be extremely careful, because at present some types of mushrooms undergo mutation and become poisonous, despite the fact that they look edible. People who do not have experience are generally not advised to pick and eat mushrooms on their own. Buying "from hands" at markets, in places of prohibited trade, etc. can also be dangerous.

Signs of poisoning by poisonous mushrooms

Poisoning by poisonous mushrooms may not manifest itself immediately, but only after some time, in the range from 30 minutes to a day after consumption (it all depends on the type of mushroom). It happens that the first symptoms appear only after 2-3 days.

The symptoms of poisoning by poisonous mushrooms are in many ways similar to those that occur with typical food poisoning:

• nausea and vomiting (sometimes with blood);
• thirst, dry mouth;
• profuse lacrimation;
• nasal congestion;
• pain syndrome;
• pronounced general weakness;
• darkening of the vision;
• headache and dizziness;
• loss of consciousness;
• severe diarrhea with blood;
• convulsions;
• lowering blood pressure;
• paleness of the skin;
• rapid pulse;
• anuria (lack of urination);
• confusion (coma).

When poisoned by the death cap, cold sticky sweat may appear, by the red fly agaric - hallucinations, asphyxia, by the toadstool - an excited state similar to a state of strong alcohol intoxication. The main danger of intoxication is that not only the gastrointestinal tract is affected, but also other vital organs. The poisons contained in inedible mushrooms (alkaloids and cytotoxins) can affect the cardiovascular system, and sometimes the central nervous system, liver and kidneys. The so-called "imaginary" period, during which the symptoms of intoxication disappear, is also dangerous. However, if treatment is not continued, the liver may fail and the person will die.

Death Cap Poisoning

Poisoning with poisonous mushrooms poses a serious threat to human health and life. Particularly dangerous is the mushroom called "death cap" (second name - "green fly agaric"), which grows in birch forests, broad-leaved and coniferous forests, oak groves and is similar in appearance to champignon and greenish russula.

Poisoning with death cap can result in death if appropriate measures are not taken in a timely manner and the patient is not taken to a medical facility. The period of intoxication consists of three stages:

• I. From 6 to 24 hours after eating a poisonous mushroom: nausea and vomiting, severe spasmodic pain in the abdomen and muscles, fever, cholera-like diarrhea with blood; respiratory distress is most often observed in children.
• II. From 2 to 4 days (latent period).
• III. Clinic of acute conditions: renal and hepatic failure with severe anuria, coagulopathy (a pathology causing bleeding), jaundice, as well as liver enlargement, convulsions, CNS depression (in severe cases – coma) and the development of heart failure.

The death cap contains extremely toxic substances that can affect liver cells, causing necrosis, and also negatively affect the kidneys, blocking their functionality. The toxins of the poisonous mushroom inhibit glycogen synthesis and oxidative phosphorylation, cause a decrease in the level of ATPase, inhibit the formation of DNA and RNA, which leads to cell autolysis.

Consequences

Poisoning with poisonous mushrooms almost always has dangerous consequences due to the large amount of toxins they contain, which can negatively affect vital organs, the psyche, the central nervous system, and the functioning of the cardiovascular system.

The consequences and degree of toxicity generally depend on the quantity and type of mushrooms eaten, as well as the effect of toxic substances on the human body. Poisoning can be mild, which is expressed by disorders in the gastrointestinal tract, but there are very severe cases of intoxication, leading to death.

To facilitate the tasks of emergency care, it is necessary to have information about the syndromes that are present in acute mushroom poisoning. For example, the respiratory failure syndrome accompanies comatose states, in which the respiratory center is depressed. Impaired consciousness (confusion, hallucinations) is caused by the effect of harmful toxins on the cerebral cortex and is often accompanied by circulatory disorders, as well as oxygen deficiency.

Mushroom poisoning can also cause other syndromes that worsen the body's condition:

• thermoregulation failure (sharp increase or decrease in body temperature);
• convulsions (an indicator of a severe degree of intoxication of the body) - occur due to oxygen starvation of brain cells as a result of the effect of toxic substances on the central nervous system;
• disturbances of water-electrolyte and acid-base balance (occur as a result of disorders in the functioning of secretory organs, functions of the digestive and excretory systems), which are accompanied by the accumulation of under-oxidized products in tissues and dehydration of the body.

The syndrome of mental disorders manifests itself as a result of intoxication with mushroom poisons, the effect of which is directed at the central nervous system. In the acute course of the process, there is a pronounced circulatory disorder, suppression of the function of the adrenal glands and the vasomotor center. The liver and kidneys suffer from intoxication to a greater extent - it is these organs that are destructively affected by toxic tissue decay products.

Complications

Poisoning with poisonous mushrooms can cause a number of complications that are dangerous to health and life, since intoxication does not pass without a trace - internal organs and systems suffer because of it, and it takes a certain amount of time to remove harmful toxins from the body.

Complications affect the functioning of three vital systems: the central nervous system, the cardiovascular system, and the respiratory system. It is very important to diagnose poisoning in a timely manner in order to prevent disability, and in severe cases, death.

Types of complications from mushroom poisoning:

• depression of cardiac function;
• tachyarrhythmia (heart rhythm disturbance) - most often against the background of a previous heart disease;
• psychosis;
• decreased vascular tone;
• hallucinations;
• hypertension;
• changes in the level of consciousness (drowsiness can vary from strong arousal);
• convulsions, in more severe cases ‒ epileptic seizures, caused by the harmful effects of the poison on the body, circulatory and metabolic disorders;
• coma (in severe cases);
• fatal outcome.

The most important condition for mushroom poisoning is timely medical care. First of all, before the ambulance arrives, the patient's stomach must be washed.

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Diagnostics

It is important to diagnose poisoning with poisonous mushrooms in a timely manner in order to prevent dangerous consequences as soon as possible.

Diagnostics must be as accurate as possible, and this requires professional skills and special laboratory equipment. If help is not provided in time, irreversible changes will occur in the body. A blood test will help identify pathological processes. Unfortunately, visible symptoms of poisoning most often become noticeable when it is too late - the liver fails or acute renal failure occurs.

Diagnostic methods include clarification of the food history (place of collection or purchase of mushrooms, time of consumption and features of their culinary processing), laboratory tests of blood, feces, vomit. Usually the diagnosis of "Acute mushroom poisoning" is made with an indication of the main pathological syndrome (for example, "acute gastroenteritis", "acute psychomotor agitation", etc.).

Diagnosis also includes measuring blood pressure (it drops significantly against the background of poisoning), monitoring the patient's condition, which may have an increased pulse rate, arrhythmia, tachycardia. With the development of acute gastroenteritis, the patient becomes dehydrated, and there is also a violation of the electrolyte composition of the blood.

If the liver is affected, jaundice, liver failure, necrosis develop, and the brain is also affected, renal failure, and nephropathy occur. Unfortunately, even resuscitation measures are unsuccessful, and the patient dies. Most often, a fatal outcome occurs with death cap poisoning: a few days of delay lead to the death of the patient.

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Tests

Poisoning with poisonous mushrooms requires a full examination of the patient, which includes measuring the pulse, blood pressure, temperature, and inhalation rate. The doctor must determine the degree of dehydration (using a urine sample), as well as possible kidney dysfunction.

Blood tests are necessary to determine the severity of the poisoning. A rectal examination is performed to determine the integrity of the rectal walls and to take a stool sample for the presence of blood and mucus. In addition, stool and vomit samples are sent to the laboratory for further testing to identify the toxin that causes the disease.

If other diseases are suspected, CT and abdominal X-rays are performed. In case of mushroom poisoning, it is recommended to collect the remains of food - they can also be useful for analysis.

It is very important to take the victim to the hospital as soon as possible, because irreversible consequences begin on the 2nd-5th day after poisoning, in particular, damage to vital organs. Death occurs from multiple organ failure in 50-95% of cases. Acute cardiovascular failure may develop against the background of intoxication, which can lead to the most severe consequences.

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Instrumental diagnostics

Poisoning with poisonous mushrooms is diagnosed based on a detailed anamnesis. The causes are established by questioning the victim. It is imperative to measure the patient's body temperature, pulse, and blood pressure. The doctor conducts a general examination of the patient, palpates the abdomen to detect pain in the umbilical and epigastric region. To identify the microorganisms that caused the intoxication, laboratory tests of feces are performed.

Instrumental diagnostics for food poisoning (including mushroom poisoning) includes:

• fibroesophagogastroduodenoscopy (examination of the mucous membrane in the upper digestive tract);
• rectoscopy (assessment of the condition of the rectum);
• colonoscopy (determining changes in the colon mucosa);
• X-ray examination (performed in case of acute poisoning).

The diagnostic method is prescribed by the doctor depending on the patient's condition, age, severity of intoxication, and symptoms. In cases of mass mushroom poisoning, the sanitary and epidemiological service conducts a study to determine the causes of mass intoxication.

Differential diagnostics

Poisoning by poisonous mushrooms is diagnosed by examining the patient, symptoms, and conducting research that helps to determine the degree of damage to the body.

Differential diagnosis is based on pronounced manifestations of enterocolitis or gastroenteritis, diarrhea, botulism, which most often develops when consuming canned mushrooms.

In case of poisoning with one of the most dangerous mushrooms – death cap, as with botulism, neurological disorders, muscle weakness, accommodation disorder, visual disturbances, anisocoria, ptosis are observed. Liver damage, acute gastroenteritis, severe diarrhea with blood and mucus occur. General weakness and thirst develop due to loss of water and salts. Unfortunately, such symptoms appear in seriously ill patients and often foretell a fatal outcome. In a patient in a comatose state, respiratory rhythm disorders and shortness of breath are possible.

Differential diagnostic factors of poisoning with poisonous mushrooms include rapid development of symptoms (from half an hour to a day). Poisoning with fly agarics provokes dilation of the pupils, profuse diarrhea and strong salivation. Blood and urine, as well as vomit, feces and food remains are subject to bacteriological examination. With the help of laboratory tests, it is possible to finally confirm the diagnosis and determine the type of toxin.

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First aid for poisoning with poisonous mushrooms

Poisoning with poisonous mushrooms can lead to serious complications, and in severe cases can be fatal. That is why it is so important to provide first aid to the victim before the doctors arrive.

First aid for poisoning with poisonous mushrooms consists of the following actions. First of all, it is necessary to induce vomiting by thoroughly washing out the stomach. Usually, a proven method is used for this purpose: you need to drink 4-6 glasses of water (boiled, cooled to room temperature) in small sips and induce vomiting by irritating the back of the throat with a finger or a teaspoon. It is recommended to repeat this procedure several times, after which put the victim to bed and apply warm heating pads to his extremities.

Before the ambulance arrives, the patient can be given warm drinks (strong tea will help if he is very weak). Activated carbon (1 gram per 1 kg of weight) will help as an absorbent. In the absence of diarrhea, a mild laxative is allowed. However, if vomiting and diarrhea occur, taking any antiemetics or laxatives is prohibited, since these natural defense mechanisms help remove toxins from the body.

The most important measure is to call an ambulance or immediately deliver the victim to a medical facility. Only an experienced doctor can prescribe the correct treatment, since the toxins of different mushrooms act differently, and, accordingly, there is no universal treatment for mushroom poisoning.

Medicines

Poisoning with poisonous mushrooms causes serious consequences, so the victim must be taken to the hospital (intensive care unit) as soon as possible. The doctor will examine the patient and prescribe treatment based on the severity of the poisoning, the patient's condition, symptoms, laboratory test results, and the type of poisonous mushroom.

Medicines used at the initial stage, when the patient has acute gastroenteritis and cardiovascular disorders, are electrolyte solutions containing magnesium, sodium, potassium, and calcium ions, administered to the patient intravenously. The action of electrolytes is aimed at correcting the water-electrolyte and acid-base balance in the body.

In case of significant fluid loss, various solutions are administered intravenously (from 5 to 8 liters per day): plasma, albumin, hemodez, neohemodez, protein, polyglucin, etc. If the patient has oliguria and anuria, saluretics are administered to stimulate diuresis, as well as lipotropic substances.

Forced diuresis will prevent detoxification. For this purpose, hemodialysis, hemofiltration, plasmapheresis, hemosorption, plasmasorption are also prescribed - blood purification methods that significantly reduce the content of toxic substances in the blood.

Among the drugs that have proven their effectiveness, we can highlight the drug Polysorb MP, the action of which is aimed at internal cleansing of the body. This enterosorbent will help get rid of unpleasant symptoms and remove toxic substances from the digestive system. White coal is a modern concentrated sorbent, often used for food poisoning. The drug actively removes toxins and slags, while leaving the useful substances necessary for the body. A good antidote is atropine, which must be administered subcutaneously. The dose of this drug is prescribed by a doctor.

In severe cases, the patient may be prescribed glucocorticoids. If necessary, norepinephrine, mesaton, and eufullin solution are administered. After the patient's condition has stabilized, treatment should continue for 4-6 months to monitor the work and condition of the internal organs. A strict diet is recommended, and hepatoprotective drugs are used.

Folk remedies

Poisoning with poisonous mushrooms requires immediate action aimed at removing toxins from the victim’s body.

Traditional treatment consists primarily of using gastric lavage. The patient should drink several glasses of warm water, to which half a teaspoon of salt should be added. It is advisable to repeat the procedure up to 6 times. After gastric lavage, it is recommended to take adsorbents (Activated carbon, White coal, Smecta, Polysorb).

In the treatment of mushroom poisoning, honey is used in a dosage of 20-25 g, diluted in warm water or tea, with mint. As adsorbents, you can use egg white (4-5 pcs. dissolved in 1 liter of warm water), starch or jelly (dissolve in water in a ratio of 1: 10).

A pre-prepared tincture of milk thistle seeds (50 g) helps well. The crushed seeds must be poured with vodka (0.5 l), infused for 2 weeks, shaking the container periodically. Take 25 drops dissolved in 0.5 glass of water, up to 5 times a day half an hour before meals. You can take drugs that contain belladonna (belladonna): bellalgin, bolloid, becarbon, as well as tincture of zelenin.

Any folk remedies in the form of tinctures should be taken only after consultation with a doctor. It is not recommended to exceed the dosage to avoid negative consequences.

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Herbal treatment

Poisoning from poisonous mushrooms can be treated with herbs that act as an antidote and help remove toxins from the body.

Herbal treatment for symptoms of intoxication:

• Melissa for nausea (pour 4 teaspoons of the herb with 2 cups of boiling water, leave for 4 hours; drink 100 g before meals three times a day).
• Herbal mixture (mint, St. John's wort, plantain, chamomile, taken in equal proportions, pour 0.5 liters of boiling water, leave for half an hour; drink the decoction often - 1/3 cup every hour).
• Chicory (powder (1 tablespoon) should be poured with 200 ml of boiling water and infused (preferably in a thermos) for 12 hours; drink 50 ml 30 minutes before meals at least 3 times a day).
• Elecampane (pour boiled water (200 ml) over the crushed root of the plant, then leave for 20 minutes; take the decoction 1 tbsp before meals 5-6 times a day).
• Blackberry (brew a small amount of plant branches (1 tablespoon per glass of water), boil for 5 minutes and let it brew; strain the resulting broth and drink in small portions within an hour).
• Herbal collection (red clover, field horsetail, oak bark (4-5 tablespoons each) - 3 tablespoons of the collection should be brewed in 1 liter of boiled water, left to stand and taken 0.5 cups frequently, up to 7 times a day).
• Dill decoction with honey (raw materials can be different: both dry and fresh greens, or plant stems): pour 1 tbsp. raw material (dill) with 200 ml of boiling water, boil over low heat for 20 minutes. Then cool, add water to the original volume, put a tablespoon of natural honey. Drink 0.5 glasses half an hour before meals.

In cases of poisoning, pharmacy tinctures of eleutherococcus and astragalus are also used, which help to expel toxins from the body. For this purpose, you can try sea microalgae (in tablets or powder).

Prevention

It is best to try to prevent poisoning with poisonous mushrooms, since untimely treatment does not always give positive results, and in severe cases of intoxication the victim may even die.

Prevention of poisoning includes following the following rules:

• Harvest only with experienced mushroom pickers.
• Avoid gathering places near railway lines, near gas, oil and chemical plants, along highways and within city limits.
• You can't eat raw mushrooms.
• It is not recommended to give them to children, elderly people, pregnant and nursing mothers.
• You cannot buy products from random people, especially in prohibited trading places.
• It is not advisable for people with gastrointestinal problems, liver problems, or kidney problems to consume mushrooms;
• Strictly adhere to the technology of cooking dishes.

It is important to remember that poisonous mushrooms often grow near edible ones, and some of their species are similar in appearance. They should not be consumed with alcohol, as this will cause a delayed toxic syndrome. It is advisable to eat mushrooms in moderation as a side dish, not as a main course (especially on an empty stomach). The shelf life is no more than a day (even in the refrigerator)!

Before pickling, it is necessary to thoroughly soak or boil the mushrooms to remove bitterness and substances that irritate the gastric mucosa. Canned mushrooms cannot be stored for more than 1 year.

Forecast

Poisoning with poisonous mushrooms can have different prognosis. Everything depends on the type of mushroom, the severity of intoxication, health condition, age of the victim. Children and elderly people tolerate poisoning the worst. Therefore, they are strictly contraindicated to eat mushrooms in any form.

The prognosis is the most unfavorable in case of poisoning with death cap: the mortality rate is from 50 to 100%. The patient's condition deteriorates sharply, hemorrhagic manifestations and hypoglycemia, a decrease in the prothrombin index are observed, which are extremely unfavorable prognostic signs. Late diagnosis and untimely treatment significantly worsen the situation.

If the poisoning occurred due to eating other poisonous mushrooms, the results of treatment will be more favorable. Mild intoxication will not lead to death, especially if the necessary measures are taken and therapy is carried out. The rehabilitation period can be from 2 to 4 weeks, and in more severe cases - up to several months. The main task is to restore the liver and other organs using modern detoxification methods.

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