An outbreak of Amanita exitialis poisoning

Figures & data

Figure 1. Mushroom samples. Mushroom samples were collected from the incident location, these were subsequently confirmed by the poisoned patients.

Table 1. Patients’ demographic characteristics and outcome.

Patient	1	2	3	4	5	6	7	8	9	10
PSS^#	1	2	2	2	2	2	2	2	3	4
Gender	M	F	M	F	M	F	M	F	M	M
Age (y)	48	47	47	49	52	49	47	50	57	51
Latency (h)	2	12	13	7	13	13	15	13	7	15
ICU-LOS (d)	5	5	5	9	5	9	5	9	7	19
H-LOS (d)	9	10	9	11	10	15	9	11	12	19
APACHE II^*	6	6	4	5	4	5	5	5	19	7
SOFA^*	1	0	1	1	2	0	0	1	7	3
Outcome	Recovered									Death

^#The grading adopts the Poisoning Severity Score (PSS) system determined by IPCS/EC/EAPCCT.

^*APACHE II and SOFA score evaluated at 24 h after admission.

M: Male; F: Female; y: years; h: hours; d: days; ICU-LOS: ICU length of stay; H-LOS: hospital length of stay; APACHE II: acute physiology and chronic health evaluation-II; SOFA: sequential organ failure assessment.

Figure 2. Represented radiographic images of abdomen. The first row of images shows patient 9, the second row shows patient 10. The images illustrate hepatic portal venous gas (red arrow) and dilated bowel (blue arrow).

Table 2. Laboratory results of patients with mushroom poisoning.

Laboratory result	All patients (n = 10)	Survivors (n = 9)	Fatality (n = 1)
AST (IU/L), median (min–max)	300 (21–2460)	297 (21–2460)	393 (49–1916)
ALT (IU/L), median (min–max)	511 (11–2537)	544 (11–2533)	397 (34–2537)
TBIL (μmol/L), median (min–max)	54.7 (6.8–573)	20.5 (6.84–373)	221 (17.1–573)
PTA (%), median (min–max)	74.1 (11–118)	83.8 (32–118)	29.3 (11–107)
aPTT (s), median (min–max)	41.9 (29.0–149)	37.9 (29.0–95)	60.7 (38.1–149)
D-dimer (μg/mL), median (min–max)	3.3 (0.2–20)	0.9 (0.2–3.2)	13.8 (0.3–20.0)
Lactate (mmol/L), median (min–max)	1.9 (0.4–9.1)	1.3 (0.4–4.7)	4.1 (1.8–9.1)
Ammonia (μmol/L), median (min–max)	54 (4.1–284)	31.7 (4.1–149)	167 (67.5–284)

AST: aspartate aminotransferase; ALT: alanine aminotransferase; TBIL: total bilirubin; PTA: prothrombin activity; aPTT: activated partial thromboplastin time; min: minimum; max: maximum; s: seconds.

Figure 3. Course of inflammatory markers in all patients. The left Y-axis corresponds to the blue line plot to reflect the time-concentration trend of CRP, and the right Y-axis corresponds to the red line plot to reflect the time-concentration trend of SAA. The average values presented in figure. The blue-broken line represents the upper limit of normal value of CRP; the red-broken line represents the upper limit of normal value of SAA. CRP: C-reactive protein; SAA: serum amyloid-A.