Korean J Gastroenterol.  2018 Feb;71(2):94-97. 10.4166/kjg.2018.71.2.94.

Mushroom Poisoning by Macrolepiota neomastoidea

• Kim SY
• Baek YH
• Han SY
• Lee SW
• Roh YH
• Kim KW
• Kang SH
• Jeong JS

• KMID: 2405002
• DOI: http://doi.org/10.4166/kjg.2018.71.2.94

Abstract

There are currently over 5,000-known species of mushrooms worldwide. Only 20-25% of mushrooms have been named, and 3% of these are poisonous. More than 95% of mushroom poisoning cases occur due to difficulties associated with the identification of mushroom species. Most of the fatal mushroom poisoning cases recorded to date have been related to the Amanita species. Until now, a case of fatal poisoning caused by Macrolepiota neomastoidea (M. neomastoidea) has not been reported in Asia. A 57-year-old male patient was admitted to the emergency room with nausea, vomiting, diarrhea, and abdominal pain. He reported ingesting wild mushrooms with his mother and sister about 2 days ago. His mother and sister were treated with only supportive care, but he was admitted to the intensive care unit and underwent liver transplantation due to acute liver failure. We are reporting a case of fatal M. neomastoidea intoxication from wild mushrooms, a rare case of mushroom poisoning.

Keyword

Macrolepiotin; Mushrooms; Acute liver failure; Poisoning

MeSH Terms

Abdominal Pain
Agaricales*
Amanita
Asia
Diarrhea
Emergency Service, Hospital
Humans
Intensive Care Units
Liver Failure, Acute
Liver Transplantation
Male
Middle Aged
Mothers
Mushroom Poisoning*
Nausea
Poisoning
Siblings
Vomiting

Figure

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  Fig. 1 (A) Macrolepiota procera. (B) Macrolepiota neomastoidea.

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  Fig. 2 Gross findings. Liver shows reddish-green discoloration by diffuse cholestasis. The weight is approximately 930 g, which is lesser than that of normal liver.

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  Fig. 3 Histopathologic findings. (A) Massive hepatocellular necrosis is present in hepatocytes. Residual viable hepatocytes show moderate macrovesicular steatosis (H&E, ×20). (B) Bile ductular proliferation (black arrows) is distinctively observed (Immunohistochemistry with anti-cytokeratin18, ×20). (C, D) There is diffuse and remarkable lobular and porto-periportal inflammation (H&E, ×100).

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