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MUSHROOMS

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Mushroom poisoning occurs in four population groups: foragers who purposefully harvest mushrooms or plants for food; teenagers and young adults who use mushrooms to get “high”; preschool-age children who accidentally ingest mushrooms while playing outdoors; and, rarely, victims of attempted homicide or suicide.

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Clinical Features

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Mushroom toxicity is divided into those with early onset, defined as within 2 hours after ingestion, and delayed onset, defined as 6 hours to 20 days after ingestion. It is important to determine if patients ingested only one type or multiple types of mushrooms and the time elapsed from ingestion to symptoms. Foragers may be able to provide a description of the mushroom. Clinical features of common mushroom poisonings are listed in Table 128-1.

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Table 128-1

Mushrooms: Symptoms, Toxicity, and Treatment

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Diagnosis and Differential

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Most patients who develop GI symptoms within 2 hours of ingestion have a reassuring clinical course and do not develop major organ failure (Table 128-1). An exception to this is Amanita smithiana ingestion, which results in early GI symptoms and delayed renal failure. Mushrooms with potential liver, kidney, and CNS effects are often associated with onset of vomiting that is delayed for 6 or more hours after ingestion. ...

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