Poisoning with poisonous mushrooms

According to statistics, of the 3,000 known fungi in our time, only 400 species are suitable for consumption, the rest are inedible and, if ingested, can cause severe intoxication. Unfortunately, recently cases of poisoning with mushrooms, bought in supermarkets, are registered more often. Improper storage and cooking of mushrooms is fraught with serious health problems. Even edible mushrooms can be dangerous because of the accumulation of harmful substances if they are grown in ecologically unfavorable areas.

Poisoning by poisonous mushrooms is most often found at the end of summer and the first half of autumn, during the harvest season, and can have serious consequences, up to a lethal outcome.

Symptoms and severity of poisoning depend on factors such as the type and amount of mushrooms eaten, the age of the affected person, the state of his health, and weight. Immunity is not able to cope with toxins that get into the body, so if you feel worse, you need to go to the hospital without delay. Children and the elderly are the least tolerant of poisoning. Death may occur several hours after the use of inedible fungi, such as, for example, pale toadstool or fly agaric, resulting in paralyzing the nervous system, stopping breathing, general intoxication, and necrosis of the liver. To prevent irreversible consequences, it is necessary to take precautionary measures in time.

ICD Code 10

Poisoning by poisonous fungi refers to food poisoning (abbreviated as PO), which are registered in the International Classification of Diseases and have a code of 10 microbes. This type of poisoning is specifically listed under the code AO-5, which stands for "other bacterial toxic infections."

Diseases of a bacterial nature are distributed as follows:

• Microbial (mycotoxicoses, botulism, staphylococcal toxicosis, various toxic infections, including mixed type);
• Non-microbial (poisoning with poisonous mushrooms, as well as certain types of fish and fish caviar);
• Toxic infections of unexplained etiology.

In food poisoning, which are caused by the use of foods with high accumulation of toxins, serious complications can arise up to the failure of the internal organs (in particular, the liver), as well as the occurrence of asphyxia, cardiac arrest. Mushroom pickers should be aware of the possible risks when harvesting in the fall season. One must be extremely cautious, because at present some species of fungi undergo a mutation and become poisonous, despite the fact that they seem edible. People who do not have experience, in general, it is undesirable to independently collect and eat mushrooms. It can also become dangerous to buy "from hand" in markets, in places of prohibited trade, etc.

Signs of Poisoning by Poisonous Mushrooms

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

The symptoms of poisoning with poisonous fungi are similar in many respects to those that occur in typical food poisoning:

• nausea and vomiting (sometimes - with an admixture of blood);
• thirst, dry mouth;
• copious lacrimation;
• nasal congestion;
• pain syndrome;
• marked general weakness;
• darkening in the eyes;
• headache and dizziness;
• loss of consciousness;
• severe diarrhea with a trace of blood;
• convulsions;
• lowering blood pressure;
• pallor of the skin;
• rapid pulse;
• anuria (absence of urination);
• confusion of consciousness (coma).

When poisoning pale toadstool can appear cold sticky sweat, red fly agaric - hallucinations, asphyxia, enigmatic fly agaric - an excited state, similar to the state of strong alcoholic intoxication. The main danger of intoxication lies in the fact that not only the digestive tract, but also other vital organs, is affected. Poisons contained in inedible fungi (alkaloids and cytotoxins) can affect the cardiovascular system, and sometimes - the central nervous system, liver and kidneys. Dangerous is also the so-called. "Imaginary" period, during which the symptoms of intoxication disappear. However, if you do not continue the treatment, the liver can refuse, and the person will die.

Poisoning with pale toadstool

Poisoning with poisonous fungi poses a serious threat to human health and life. Particularly dangerous is the fungus called "pale toadstool" (the second name is "fly agaric"), which grows in birch forests, broad-leaved and coniferous forests, oak forests and looks similar to a champignon and a greenish russet.

Poisoning with a pale toadstool can result in the death of a person unless timely measures are taken and the patient is not taken to a medical institution. The period of intoxication is three stages:

• I. From 6 to 24 hours after consuming a poisonous fungus: nausea and vomiting, severe spastic pain in the abdomen and muscles, fever, cholera-like diarrhea with a trace of blood; Respiratory disorders are most often observed in children.
• II. From 2 to 4 days (latent period).
• III. Clinic of acute conditions: renal and hepatic insufficiency with pronounced anuria, coagulopathy (pathology causing bleeding), jaundice, as well as liver enlargement, seizures, CNS depression (in severe cases - coma) and the development of heart failure.

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

Effects

Poisoning with poisonous mushrooms almost always has dangerous consequences due to the content of a large number of toxins that can adversely affect vital organs, the psyche, the central nervous system and the work of the cardiovascular system.

The consequences and the degree of toxicity generally depend on the amount and type of eaten mushrooms, as well as the effects of toxic substances on the human body. Poisoning can be easy, which is manifested by disorders in the digestive tract, but there are very serious cases of intoxication, leading to death.

To facilitate the tasks of emergency care, you need to know information about the syndromes that are present in acute poisoning with fungi. For example, the syndrome of breathing disorder accompanies comatose conditions, in which the respiratory center is depressed. Violation of consciousness (confusion, hallucinations) is due to the influence of harmful toxins on the cerebral cortex and is often accompanied by a disorder of blood circulation, as well as oxygen deficiency.

When poisoning with fungi, other syndromes that worsen the state of the body can develop:

• failure of thermoregulation (sudden rise or fall of body temperature);
• convulsions (an indicator of a serious degree of intoxication of an organism) - arise because of oxygen starvation of brain cells as a result of exposure to toxic substances on the CNS;
• violations of water-electrolyte and acid-base balance (appear due to disruption of the secretory organs, functions of the digestive and excretory systems), which are accompanied by the accumulation of undi-oxidized products in the tissues and dehydration of the body.

The syndrome of mental disorders manifests itself as a result of toxicity with fungal poisons, the action of which is directed to the central nervous system. In the acute course of the process, a marked violation of blood circulation, suppression of the function of the adrenal and vasomotor center. To a greater extent, liver and kidneys suffer from intoxication, namely, these organs are exerted by the destructive effect of toxic products of tissue decay.

Complications

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

Complications concern the operation of three vital systems: central nervous, cardiovascular and respiratory. It is very important to diagnose poisoning in time to prevent disability, and in case of severe poisoning, death.

Types of complications when poisoning fungi:

• oppression of cardiac function;
• tachyarrhythmia (violation of the heart rhythm) - most often on the background of a previous heart disease;
• psychosis;
• decreased vascular tone;
• hallucinations;
• hypertension;
• change in the level of consciousness (drowsiness can vary with strong arousal);
• seizures, in more severe cases - epileptic seizures, caused by the harmful effects of poison on the body, blood flow and metabolism disorders;
• coma (in severe cases);
• death.

The most important condition for poisoning with fungi is the timely provision of medical care. First of all, before the ambulance arrives the patient needs to rinse the stomach.

[1], [2], [3]

Diagnostics

Poisoning with poisonous mushrooms is important in a timely manner to diagnose to prevent dangerous consequences.

Diagnosis should be as accurate as possible, and this requires professional skills and special laboratory equipment. If help is not provided on time, irreversible changes will occur in the body. To identify pathological processes will help the analysis of blood. Unfortunately, the visible symptoms of poisoning most often become noticeable when it's too late, - the liver fails or acute kidney failure occurs.

Diagnostic methods include the specification of a food history (the place of gathering or buying mushrooms, the time of consumption and the peculiarities of their culinary processing), laboratory tests of blood, feces, vomit. Usually the diagnosis "Acute mushroom poisoning" is indicated with the indication of the main pathological syndrome (for example, "acute gastroenteritis", "acute psychomotor agitation", etc.).

Diagnosis also includes the measurement of blood pressure (against the background of poisoning it decreases significantly), control over the patient's condition, which can increase the pulse, there is arrhythmia, tachycardia. With the development of acute gastroenteritis in the patient is dehydration of the body, as well as a violation of electrolyte blood.

If the liver is affected, jaundice, hepatic insufficiency, necrosis, as well as the brain is affected, kidney failure, nephropathy occurs. Unfortunately, even resuscitation is unsuccessful, and the patient dies. Most often, lethal outcome occurs when poisoning with a pale toadstool: several days of delay lead to the death of the patient.

[4], [5], [6], [7],

Analyzes

Poisoning with poisonous fungi requires a complete examination of the patient, which includes measuring the pulse, pressure, temperature, inspiratory speed. The doctor should establish the degree of dehydration (using a urine sample), as well as possible disruption of the kidneys.

Blood tests are necessary to determine the severity of poisoning. Rectal examination is performed to determine the integrity of the rectal walls and take a specimen of feces for the presence of blood and mucus admixtures. In addition, samples of stool and vomiting are sent to the laboratory for further testing for the detection of toxin, the causative agent of the disease.

If suspected of other diseases, CT and x-ray of the abdomen are performed. When poisoning with mushrooms is recommended to collect the remains of food - they can also come in handy for analysis.

It is very important to take the victim to the hospital as soon as possible, because on the 2-5th day after the poisoning irreversible consequences begin, in particular, damage to vital organs. From multiorgan failure, death occurs in 50-95% of cases. On the background of intoxication, it is possible to develop acute cardiovascular insufficiency, which can lead to the most severe consequences.

[8], [9], [10], [11], [12]

Instrumental diagnostics

Poisoning by poisonous mushrooms is diagnosed on the basis of a detailed anamnesis. Reasons are established when the victim is interviewed. Without fail it is necessary to measure the patient's body temperature, pulse, blood pressure. The doctor conducts a general examination of the patient, performs palpation of the abdomen to identify pain in the perigapic and epigastric region. Laboratory studies of feces are performed to identify microorganisms that have caused intoxication.

Instrumental diagnostics for food poisoning (including fungi) includes:

• fibroesophagogastroduodenoscopy (examination of the mucosa in the upper parts of the digestive tract);
• sigmoidoscopy (assessment of the condition of the rectum);
• Colonoscopy (definition of changes in the mucosa of the large intestine);
• fluoroscopy (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 massive fungal poisoning by the sanitary and epidemiological service, a study is being conducted, which explains the causes of mass intoxication.

Differential diagnostics

Poisoning by poisonous fungi is diagnosed by examining the patient, symptomatology, conducting studies that help 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 with the use of canned mushrooms.

When one of the most dangerous fungi is poisoned - pale toadstool, as in botulism, neurological disorders, muscle weakness, disruption of accommodation, visual disturbances, anisocoria, ptosis are observed. There is liver damage, acute gastroenteritis, severe diarrhea with an admixture of blood and mucus. Due to loss of water and salts, general weakness and thirst develop. Unfortunately, such symptomatology is manifested in severe patients and often portends a lethal outcome. In a patient who is in a coma, there may be disorders of the respiratory rhythm, development of dyspnea.

To differential-diagnostic factors of poisoning with poisonous fungi can be attributed to the rapid development of symptoms (from half an hour to a day). Poisoning with fly agarics provokes the dilatation of pupils, profuse diarrhea and strong salivation. Blood and urine, as well as vomit, bowel movements and food debris are subjected to bacteriological examination. With the help of laboratory studies, definitive confirmation of the diagnosis and determination of the type of toxin is possible.

[13], [14], [15], [16], [17]

First aid for poisoning with poisonous mushrooms

Poisoning with poisonous fungi is fraught with serious complications, and in severe cases leads to death. Therefore, it is so important to give the victim first aid before the doctors arrive.

The first help in poisoning with poisonous mushrooms is to perform the following actions. First of all, it is necessary to induce vomiting, after thoroughly washing the stomach. Usually, a proven method is used for this purpose: it is necessary to drink 4 to 6 glasses of water in small sips (boiled, cooled to room temperature) and induce vomiting, irritating the back wall of the pharynx with a finger or a tea spoon. This procedure is recommended to repeat several times, then put the person in bed and apply warm heaters to his limbs.

Before the arrival of the "ambulance" patient can be given a warm drink (with strong weakness will help strong tea). As an absorbent, activated charcoal (1 gram per 1 kg of weight) will help. In the absence of diarrhea, it is allowed to take a mild laxative. However, with vomiting and diarrhea, taking any antiemetic and laxatives is prohibited, since these natural protective mechanisms help to remove toxins from the body.

The most important action is to call an "ambulance" or immediately deliver the victim to a medical facility. Only an experienced doctor will be able to prescribe the right treatment, since the toxins of different fungi act differently, and, accordingly, there is no universal treatment for poisoning by fungi.

Medications

Poisoning with poisonous fungi causes severe consequences, so the injured person should be taken to the hospital as soon as possible (to the intensive care unit). The doctor will examine the patient and prescribe the treatment, based on the severity of the poisoning, the patient's condition, symptoms, the results of laboratory tests, the type of poisonous fungus.

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

With a significant loss of fluid, intravenous administration of various solutions (from 5 to 8 liters per day) is carried out: plasma, albumin, hemodez, neohemodez, protein, polyglucin, etc. If a patient has oliguria and anuria, saluretics are administered to stimulate diuresis, as well as lipotropic substances.

Diuresis forced will prevent detoxification. To this end, hemodialysis, hemofiltration, plasmapheresis, hemosorption, plasmosorption - blood purification methods, which significantly reduce the content of toxic substance in the blood, are also prescribed.

Of the drugs, the use of which has proved to be effective, it is possible to isolate the preparation Polysorb MP, the action of which is aimed at internal cleansing of the body. This enterosorbent will help to 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 toxins, while leaving 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, enter norepinephrine, mezaton, a solution of eufullin. After stabilizing the patient's condition, treatment should continue for 4-6 months to monitor the work and condition of the internal organs. A strict diet is recommended, hepatoprotective drugs are used.

Alternative treatment

Poisoning with poisonous mushrooms requires urgent action aimed at removing toxins from the body of the victim.

Alternative treatment consists, first of all, in the use of means for rinsing the stomach. The patient should drink a few glasses of warm water, in which you need to add half a teaspoon of salt. It is desirable to repeat the procedure up to 6 times. After washing the stomach, it is recommended to take adsorbents (Activated Carbon, White Coal, Smecta, Polysorb).

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

A well-prepared tincture of seeds of the milk thistle grass (50 g) helps a lot. Shredded seeds should be filled with vodka (0.5 liters), infused for 2 weeks, periodically shaking the container. Take 25 drops dissolved in a 0.5 glass of water, up to 5 times a day for half an hour before meals. You can take drugs that contain belladonna (belladonna): bellalgin, bolloid, bicarbon, and tincture of greenery.

Any alternative means in the form of infusions should be taken only after consultation with the doctor. Do not exceed the dosage to avoid negative consequences.

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Herbal Treatment

Poisoning by poisonous fungi can be treated with herbs, which serve as antidotes and help remove toxins from the body.

Treatment with herbs when symptoms of intoxication:

• Melissa from nausea (4 tsp herbs pour 2 items of steep boiling water, insist 4 hours, drink 100 g before meals three times a day).
• Herbal mixture (mint, St. John's wort, plantain, chamomile, taken in equal proportions, are poured with 0.5 liters of boiling water, insist half an hour, you should drink the broth frequently - 1/3 cup every hour).
• Chicory (powder (1 tablespoon) it is necessary to pour 200 ml of boiling water and insist (preferably in a thermos) for 12 hours, drink 50 ml 30 minutes before meals at least 3 times a day).
• Devyasil (crushed root of the plant pour boiled water (200 ml), then insist for 20 minutes, take a decoction of 1 tablespoon before meals 5-6 times a day).
• Blackberry (a small amount of plant twigs to brew (1 tablespoon per glass of water), boil for 5 minutes and insist, the resulting broth should be filtered and drunk in small portions for an hour).
• Herbal collection (clover meadow, field horsetail, oak bark (4-5 tablespoons) - 3 tablespoons of the spoon should be brewed in 1 liter of boiled water, stand and take 0.5 cups often, up to 7 times a day ).
• Broth of dill with honey (raw materials can be different: both dry and fresh herbs, or stems of the plant): 1 tbsp. L. Raw (dill) pour 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 cup for half an hour before meals.

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

Prevention

Poisoning by poisonous mushrooms is best to prevent, because untimely treatment does not always give positive results, and in severe cases of intoxication, the victim may even die.

Prevention of poisoning includes compliance with the following rules:

• Harvest with experienced mushroom pickers only.
• Avoid gathering places near railway tracks, near gas, oil and chemical industries, along highways and in the city.
• You can not try raw mushrooms.
• It is not recommended to give them to children, the elderly, pregnant and lactating mothers.
• You can not buy food from random people, especially in prohibited trading areas.
• It is undesirable to use fungi to people who have problems with the digestive tract, liver, kidneys;
• Strictly observe the technology of cooking.

It should be remembered that poisonous mushrooms often grow edible, and some of their species have an external similarity. You can not use them with alcohol - this will cause a delayed toxic syndrome. It is desirable to moderate consumption of mushrooms as a side dish, not the main course (especially on an empty stomach). Shelf life - no more than a day (even in the refrigerator)!

Before salting it is necessary to thoroughly soak or boil the mushrooms to remove the bitterness and substances that irritate the gastric mucosa. You can not store canned mushrooms for more than 1 year.

Forecast

Poisoning by poisonous mushrooms can have a different prognosis. Everything depends on the type of fungi, the severity of intoxication, the state of health, the age of the victim. Worst of all, poisoning children and elderly people suffer. Therefore, they categorically contraindicated the use of fungi, in whatever form.

The prognosis is the most unfavorable for poisoning with pale toadstool: the death 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 is an extremely unfavorable prognostic sign. Late diagnosis and untimely treatment significantly exacerbate the situation.

If poisoning is due to eating other poisonous fungi, the results of treatment will be more favorable. A mild degree of intoxication will not lead to death, especially if the necessary measures and therapy are taken. 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 methods of detoxification.

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