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Mushroom Poisoning in the Northeast of Iran; a Retrospective 6-Year Epidemiologic Study

Bita Dadpour, Shahrad Tajoddini, Maliheh Rajabi, Reza Afshari




Introduction: Toxic mushrooms are distributed across the globe with over 5000 species. Among them, 100 species are responsible for most of the cases of mushroom poisoning. This study aimed to evaluate the epidemiologic pattern of mushroom poisoning among patients referred to the main toxicology center of Mashhad province located in North-east of Iran.

Method: This cross-sectional study was conducted on patients with final diagnosis of mushroom poisoning referred to the toxicology center of Mashhad, Iran, from February 2005 to 2011. Patients’ demographic characteristics, clinical presentations, laboratory findings, outcomes, and therapeutic measures were collected using a predesigned checklist and searching patient’s profile.

Results: 32 cases with the mean age of 24.6 ± 16.7 years were presented to the toxicology center following mushroom poisoning (59% female). Mushroom poisoning accounted for 0.1% of all admitted cases. The mean time elapsed from consumption to referral to poisoning department was 61.9 ± 49.4 hours. 19 (59%) cases were discharged with complete recovery, 7 (22%) expired, and 6 (19%) cases left hospital against medical advice. Mushroom poisoning mortality accounted for 1.5% of deceased cases in the studied center. There was significant relationship between mortality rate and higher values of INR (p = 0.035), PT (p = 0.011) and PTT (p = 0.003). Likewise, there was significant relationship between the need for mechanical ventilation and higher values of INR (p = 0.035), PT (p = 0.006) and PTT (p = 0.014). The relationships between the need for ICU admission, mechanical ventilation, and mortality rate with the rise of hepatic transaminases and serum bilirubin were not significant.

Conclusion: Based on the findings, the prevalence of mushroom poisoning among patients referred to Mashhad toxicology center was very low (0.1%), but with a high mortality rate of 22%. Nausea and vomiting were the most common early symptoms of intoxication and higher values of coagulation profile were correlated with poor outcome.


Mushroom poisoning; epidemiology; mortality; toxicology; Iran


Erguven M, Yilmaz O, Deveci M, Aksu N, Dursun F, Pelit M, et al. Mushroom poisoning. Indian journal of pediatrics. 2007;74(9):847-52.

Yardan T, Baydin A, Eden AO, Akdemir HU, Aygun D, Acar E, et al. Wild mushroom poisonings in the Middle Black Sea region in Turkey: analyses of 6 years. Human & experimental toxicology. 2010.

Bergis D, Friedrich-Rust M, Zeuzem S, Betz C, Sarrazin C, Bojunga J. Treatment of Amanita Phalloides Intoxication by Fractionated Plasma Separation and Adsorption (Prometheus®). J Gastrointestin Liver Dis. 2012;21(2):171-6.

Ganzert M, Felgenhauer N, Schuster T, Eyer F, Gourdin C, Zilker T. [Amanita poisoning--comparison of silibinin with a combination of silibinin and penicillin]. Deutsche medizinische Wochenschrift (1946). 2008;133(44):2261-7.

Broussard CN, Aggarwal A, Lacey SR, Post AB, Gramlich T, Henderson JM, et al. Mushroom poisoning—from diarrhea to liver transplantation. The American journal of gastroenterology. 2001;96(11):3195-8.

Jan MA, Siddiqui TS, Ahmed N, Ul-Haq I, Khan Z. Mushroom poisoning in children: clinical presentation and outcome. J Ayub Med Coll Abbottabad. 2008;20(2):99-101.

Aji DY, Çalişkan S, Nayir A, Mat A, Can B, Yaşar Z, et al. Haemoperfusion in Amanita phalloides poisoning. Journal of tropical pediatrics. 1995;41(6):371-4.

Nelson L. Goldfrank's toxicologic emergencies: McGraw-Hill Medical New York:; 2011.

Pajoumand A, Shadnia S, Efricheh H, Mandegary A, Hassanian-Moghadam H, Abdollahi M. A retrospective study of mushroom poisoning in Iran. Human & experimental toxicology. 2005;24(12):609-13.

Saadatm S, Azarbooyeh F. New records of fungi from Iran. African Journal of Biotechnology. 2012;11(8):1900-3.

Barbee GA, Berry-Cabán CS, Barry JD, Borys DJ, Ward JA, Salyer SW. Analysis of mushroom exposures in Texas requiring hospitalization, 2005–2006. Journal of medical toxicology. 2009;5(2):59-62.

Iliev Y, Andonova S, Akabaliev V. Our experience in the treatment of acute Amanita phalloides poisoning. Folia medica. 1998;41(4):30-7.

Covic A, Goldsmith DJ, Gusbeth‐Tatomir P, Volovat C, Dimitriu AG, Cristogel F, et al. Successful use of Molecular Absorbent Regenerating System (MARS) dialysis for the treatment of fulminant hepatic failure in children accidentally poisoned by toxic mushroom ingestion. Liver international. 2003;23(s3):21-7.

Chen W-C, Kassi M, Saeed U, Frenette CT. A rare case of amatoxin poisoning in the state of Texas. Case reports in gastroenterology. 2012;6(2):350-7.

Kaufmann P. [Mushroom poisonings: syndromic diagnosis and treatment]. Wiener medizinische Wochenschrift (1946). 2006;157(19-20):493-502.

Pertile N, Galliani E, Vergerio A, Turrin A, Caddia V. [The Amanita phalloides syndrome. Case of a 2-year-old girl]. La Pediatria medica e chirurgica: Medical and surgical pediatrics. 1989;12(4):411-4.

Benítez-Macías J, García-Gil D, Brun-Romero F, Nogué-Xarau S. [Acute mushrooms poisoning]. Revista clinica espanola. 2009;209(11):542-9.

DOI: https://doi.org/10.22037/emergency.v5i1.13607


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