Ward Jeanine, Kapadia Kishan, Brush Eric, Salhanick Steven D
University of Massachusetts Medical School, Worcester Massachusetts 01655, USA.
J Emerg Med. 2013 Jan;44(1):116-21. doi: 10.1016/j.jemermed.2012.02.020. Epub 2012 May 1.
Diagnosis and management of Amanita mushroom poisoning is a challenging problem for physicians across the United States. With 5902 mushroom exposures and two resultant deaths directly linked to Amanita ingestion in 2009, it is difficult for physicians to determine which patients are at risk for lethal toxicity. Identification of amatoxin poisoning can prove to be difficult due to delay in onset of symptoms and difficulty with identification of mushrooms. Consequently, it is difficult for the Emergency Physician to determine proper disposition. Further, treatment options are controversial.
To review current data to help health care providers effectively identify and treat potentially deadly Amanita mushroom ingestions.
We present two cases of Amanita mushroom ingestion in the northeastern United States treated with N-acetylcysteine, high-dose penicillin, cimetidine, and silibinin, a semi-purified fraction of milk thistle-derived silymarin, as part of their treatment regimen. The mushroom species was identified by a consultant as Amanita Ocreata.
We present the successful treatment of 2 patients who ingested what we believe to be an Amanita species never before identified in the northeastern United States.
对于美国各地的医生来说， Amanita蘑菇中毒的诊断和处理是一个具有挑战性的问题。2009年，有5902例蘑菇暴露事件，其中两例死亡直接与摄入Amanita蘑菇有关，医生很难确定哪些患者有致命毒性的风险。由于症状出现延迟以及蘑菇识别困难， amatoxin中毒的鉴定可能很困难。因此，急诊医生很难确定正确的处理方式。此外，治疗方案存在争议。
回顾当前数据，以帮助医疗保健提供者有效识别和治疗潜在致命的Amanita蘑菇摄入中毒。
我们报告美国东北部两例Amanita蘑菇摄入中毒病例，作为治疗方案的一部分，他们接受了N - 乙酰半胱氨酸、大剂量青霉素、西咪替丁和水飞蓟宾（水飞蓟素的半纯化成分）治疗。一位顾问鉴定该蘑菇种类为赭盖鹅膏菌。
我们成功治疗了2例摄入我们认为是美国东北部此前从未鉴定过的Amanita蘑菇种类的患者。
