Doan Uyen Vy, Mendez Rojas Bomar, Kirby Ralph
a Clinical Toxicology , Cho Ray Hospital , Ho Chi Minh City , Vietnam.
b International Health Program, National Yang-Ming University , Taipei , Taiwan.
Clin Toxicol (Phila). 2017 Sep;55(8):893-896. doi: 10.1080/15563650.2017.1319066. Epub 2017 May 2.
Cordyceps fungus found in infected cicada nymphs ("cicada flowers") is utilized in traditional Chinese medicine. Cordyceps fungus toxicity in humans has not been previously reported. We report 60 cases of apparent Cordyceps poisoning in Southern Vietnam.
We retrospectively collected demographic and clinical data from the medical records (21 cases) and by telephone interview (39 cases) of patients admitted to seven hospitals in Southern Vietnam following ingestion of cicada flowers between 2008 and 2015. We also determined the species of Cordyceps present in the cicada flowers and performed a partial chemical analysis of the fungus.
Sixty cases of toxic effects following ingestion of cicada flowers were documented. Symptom onset occurred within 60 minutes following ingestion. Symptoms included dizziness, vomiting, salivation, mydriasis, jaw stiffness, urinary retention, seizures, agitated delirium, hallucinations, somnolence and coma. None of the patients suffered liver or kidney injury. There was one fatality. The Cordyceps fungus involved in these poisoning was identified as Ophiocordyceps heteropoda. The presence of ibotenic acid was confirmed, but musimol and muscarine were absent.
Cicada infected with Ophiocordyceps heteropoda in Vietnam contain ibotenic acid and are associated with a clinical syndrome consistent with its effects.
在被感染的蝉若虫（“蝉花”）中发现的虫草菌被用于传统中药。此前尚未有关于虫草菌对人类毒性的报道。我们报告了越南南部60例明显的虫草中毒病例。
我们回顾性收集了2008年至2015年期间在越南南部七家医院因食用蝉花而入院患者的病历（21例）和通过电话访谈（39例）获得的人口统计学和临床数据。我们还确定了蝉花中存在的虫草菌种，并对该真菌进行了部分化学分析。
记录了60例食用蝉花后的中毒效应病例。症状在摄入后60分钟内出现。症状包括头晕、呕吐、流涎、瞳孔散大、牙关紧闭、尿潴留、癫痫发作、激越性谵妄、幻觉、嗜睡和昏迷。所有患者均未出现肝或肾损伤。有1例死亡。这些中毒事件中涉及的虫草菌被鉴定为异足虫草。证实存在鹅膏蕈氨酸，但不存在蝇蕈醇和毒蝇碱。
越南感染异足虫草的蝉含有鹅膏蕈氨酸，并与与其作用相符的临床综合征相关。
