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野生蘑菇中毒:含鹅膏蕈碱蘑菇的案例研究及其对公共卫生的影响。

Wild mushroom poisoning: A case study of amatoxin-containing mushrooms and implications for public health.

机构信息

Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China.

Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China.

出版信息

Toxicon. 2024 Mar;240:107639. doi: 10.1016/j.toxicon.2024.107639. Epub 2024 Feb 3.

DOI:10.1016/j.toxicon.2024.107639
PMID:38311256
Abstract

Wild mushroom poisoning is a global public health concern, with mushrooms containing amatoxins being the main cause of fatalities. Mushrooms from the genus Amanita and Galerina contain amatoxins. Here we present a case of wild mushroom poisoning that affected three individuals, resulting in two fatalities. Within 10-15 hours after consumption, they experienced symptoms of gastroenteritis such as vomiting, abdominal pain, and diarrhea. One individual sought medical attention promptly and recovered, while the other two sought medical help nearly two or three days after the onset of symptoms, by which time their conditions had already worsened and led to their deaths. The mushrooms were identified belonging to genus Galerina, and laboratory test revealed variations in toxin levels among mushrooms collected from different parts of the decaying stump. The higher levels of α-amanitin, β-amanitin, and γ-amanitin were detected near the base of the tree stump, but trace levels of α-amanitin were found near the top of the stump, while β-amanitin and γ-amanitin were undetectable. This case emphasizes the importance of seeking immediate medical attention when experiencing delayed-onset gastrointestinal symptoms, as it may indicate more severe mushroom poisoning, particularly amatoxin poisoning. Timely and appropriate treatment is equally important. Additionally, consuming different units of the mushrooms in the same incident can lead to varying prognoses due to differences in toxin levels.

摘要

野生蘑菇中毒是一个全球性的公共卫生问题,含鹅膏肽类毒素的蘑菇是导致死亡的主要原因。鹅膏菌属和鹅膏菌属的蘑菇含有鹅膏肽类毒素。本文报告了一起野生蘑菇中毒事件,涉及 3 人,其中 2 人死亡。食用后 10-15 小时,他们出现肠胃炎症状,如呕吐、腹痛和腹泻。1 人及时就医并康复,而另外 2 人在症状出现近 2-3 天后才寻求医疗帮助,此时他们的病情已经恶化,导致死亡。蘑菇被鉴定为鹅膏菌属,实验室检测显示,从腐烂树桩不同部位采集的蘑菇毒素水平存在差异。在靠近树桩底部的地方检测到较高水平的α-鹅膏肽、β-鹅膏肽和γ-鹅膏肽,但在靠近树桩顶部的地方仅检测到痕量的α-鹅膏肽,而β-鹅膏肽和γ-鹅膏肽则无法检测到。本病例强调了出现迟发性胃肠道症状时应立即就医的重要性,因为这可能表明蘑菇中毒更严重,特别是鹅膏肽类毒素中毒。及时和适当的治疗同样重要。此外,在同一事件中食用同一蘑菇的不同部位可能会因毒素水平的差异而导致不同的预后。

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