Roy Sayak, Saleem Huzaifa
Acute Medicine, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, Orpington, GBR.
Cureus. 2024 Dec 14;16(12):e75706. doi: 10.7759/cureus.75706. eCollection 2024 Dec.
Mushrooms have always found their way into our dining plates due to their exotic looks and edibility. It is also one of the food items that can lead to fatal hepatotoxicity if the wrong species is picked up. Mushroom poisoning is frequently seen in forest adventure seekers and presents with variable time frames, mainly with acute gastrointestinal symptoms. Here we discuss a case of mushroom poisoning in a lady in her early sixties who presented with acute liver injury after 6 hours of wild toxic mushroom intake, having severely raised INR (International Normalized Ratio). She was managed with N-acetylcysteine (NAC), vitamin K, and regular benzylpenicillin in the liver-intensive therapy unit (ITU). The data regarding the treatment of mushroom poisoning is not tested in conventional rigorous randomized control trials. However, the role of good supportive care in liver-ITU, the addition of NAC, and benzylpenicillin in some cases, is reassuring. And if that fails, then liver transplant is a viable option. Her case underscores the critical importance of early diagnosis and immediate initiation of supportive care, including the addition of NAC and regular benzylpenicillin in selected cases. For those not responding to these conventional therapies, the possibility of a liver transplant, as a last resort, must be considered.
蘑菇因其独特的外观和可食用性，一直出现在我们的餐盘里。它也是一种如果误食错误品种就可能导致致命肝毒性的食物。蘑菇中毒在森林探险者中很常见，中毒后的症状出现时间各不相同，主要表现为急性胃肠道症状。在此，我们讨论一例六十岁出头女性的蘑菇中毒病例，她在误食野生毒蘑菇6小时后出现急性肝损伤，国际标准化比值（INR）严重升高。她在肝脏重症监护病房（ITU）接受了N - 乙酰半胱氨酸（NAC）、维生素K和常规苄星青霉素治疗。关于蘑菇中毒治疗的数据尚未在传统的严格随机对照试验中得到验证。然而，在肝脏ITU进行良好的支持性护理、添加NAC以及在某些情况下使用苄星青霉素，效果是可靠的。如果这些方法失败，肝移植是一个可行的选择。她的病例凸显了早期诊断和立即开始支持性护理的至关重要性，包括在特定病例中添加NAC和常规苄星青霉素。对于那些对这些传统疗法无反应的患者，作为最后手段，必须考虑肝移植的可能性。
