Kohn R, Mot'ovská Z
I. interná klinika Dérerovej nemocnice a katedra vnútorného lekárstva IVZ, Bratislava.
Vnitr Lek. 1997 Apr;43(4):230-3.
The most serious poisonings are the hepatotoxic ones which are caused above all by Amanita phalloides, virosa, verna, Lepiota helveola, Galerina marginata, Gyromitra esculenta, Hypholoma fasciculare, and nephroptoxic intoxications which are caused above all by Cortinarius orrelanus and Paxillus involutus. Neurotoxic and psychotropic intoxications develop after ingestion of Inocybe, Clitocybe, Amanita-panterina, muscaria and Psilocybe. Most frequently the gastroenteric type of mushroom poisoning is encountered which is caused by many species e.g. Boletus satanas, Entoloma sinuatum and others. In the diagnosis anamnestic data are used, the clinical picture, mycological and toxicological examinations of residues of mushrooms, their spores and toxins. Therapeutic strategy comprises elimination methods gastric lavage, intestinal lavage and administration of large amounts of animal charcoal, forced diuresis, haemoperfusion, haemodialysis or peritoneal dialysis, administration of antidotes and symptomatic treatment, i.e. mainly rehydration and restoration of the mineral balance. Early and comprehensive treatment are important.
最严重的中毒是肝毒性中毒,主要由毒鹅膏、鳞柄白鹅膏、白毒鹅膏、黄斑褶伞、墨汁鬼伞、鹿花菌、簇生垂幕菇引起;以及肾毒性中毒,主要由赭红拟口蘑和卷边桩菇引起。摄入丝盖伞属、杯伞属、毒蝇鹅膏、毒蝇伞和裸盖菇属后会发生神经毒性和精神性中毒。最常见的是胃肠型蘑菇中毒,由许多物种引起,如撒旦牛肝菌、凹缘粉褶蕈等。诊断时使用既往病史资料、临床表现、蘑菇残渣、其孢子和毒素的真菌学及毒理学检查。治疗策略包括清除方法,如洗胃、肠道灌洗和给予大量活性炭、强制利尿、血液灌流、血液透析或腹膜透析、给予解毒剂和对症治疗,即主要是补液和恢复矿物质平衡。早期和综合治疗很重要。