Kaufmann Peter
Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Osterreich.
Wien Med Wochenschr. 2007;157(19-20):493-502. doi: 10.1007/s10354-007-0465-z.
The major syndromes of mushroom poisoning can be divided by presentation timing: Early syndromes (symptom onset <6 hrs after ingestion) have little probability to cause organ damage. Epigastric pain, nausea, vomiting and diarrhea occur in most cases and treatment includes initial gastrointestinal decontamination with oral activated charcoal and fluid rehydration. In addition, an acute gastrointestinal syndrome can be combined with cholinergic toxicity, epileptiformic response or immuno-hemolytic anemia. Neurotoxic Syndromes may present as dysphoria, delirium, hallucinations or disulfiram-like reactions. Treatment is entirely supportive and if performed in hospital, the prognosis is good. Late syndromes (symptom onset >6 hrs after ingestion) are life-threatening due to liver- and renal failure. Patients who are jaundiced after an acute gastrointestinal episode, are suspected to be poisoned with Amatoxins. Patients with flank pain, hematuria, polyuria or oliguria in the absence of jaundice are suspected to have an intoxication with Cortinarius mushrooms. In both cases an intensive care management is indicated.
早期综合征（摄入后症状发作<6小时）很少导致器官损伤。大多数情况下会出现上腹部疼痛、恶心、呕吐和腹泻，治疗包括先用口服活性炭进行胃肠道去污以及补液。此外，急性胃肠综合征可伴有胆碱能毒性、癫痫样反应或免疫性溶血性贫血。神经毒性综合征可能表现为烦躁不安、谵妄、幻觉或双硫仑样反应。治疗完全是支持性的，如果在医院进行，预后良好。晚期综合征（摄入后症状发作>6小时）因肝肾功能衰竭而危及生命。急性胃肠发作后出现黄疸的患者，怀疑是由鹅膏毒素中毒。无黄疸但有胁腹痛、血尿、多尿或少尿的患者，怀疑是由丝膜菌属蘑菇中毒。在这两种情况下，都需要进行重症监护管理。
