Mushroom poisoning - From diarrhea to liver transplantation

Mushroom poisoning from the genus Amanita is a medical emergency, with Aman ita phalloides being the most common species. The typical symptoms of nause a, vomiting, abdominal pain, and diarrhea are nonspecific and can be mistak en for gastroenteritis. If not adequately treated, hepatic and renal failur e may ensue within several days of ingestion. In this case series, patients poisoned with Amanita virosa are described with a spectrum of clinical pre sentations and outcomes ranging from complete recovery to fulminant. hepati c failure. Although there are no controlled clinical trials, a few anecdota l studies provide the basis for regimens recommended to treat Amanita poiso ning. Use of i.v. penicillin G is supported by most reports. Silibinin, alt hough preferred over penicillin, is not easily available in the United Stat es. In those with acute liver failure, liver transplantation can be life sa ving. (C) 2001 by Am. Coll. of Gastroenterology.