[Successful treatment in a case of podostroma cornu-damae poisoning, a deadly poisonous mushroom].
In this case study, a 62-year-old man ate a piece of of Podostroma cornu-damae, poisonous mushroom, by mistake and suffered from severe diarrhea, vomiting and dehydration. The next day he received about 9 liters of solution intravenously over a 12 hour period at his neighboring hospital. The mushroom was identified as Podostroma cornu-damae and he was transported to our hospital on the same day. When he arrived, hypotension due to high capillary permeability accompanied by protein leakage, Leukocytosis, and faint erythema on the body were observed. He was immediately treated by continuous hemodiafiltration (CHDF) and large quantities of solution were given while monitoring the patient's pulmonary capillary wedge pressure and cardiac output. On the seventh day, Leukocytopenia and thrombocytopenia became severe and hemophagocytosis was observed. Plasma exchange (PE) and granulocyte colony stimulating factor (GCSF) were effectively used to treat these hematological disorders. In addition, hypouricemia was also observed, severe depilation occurred, and the skin lesions gradually changed to lameller desquamation. The patient needed over 30 days to recover from leukocytopenia.


CONCLUSIONS
It is important to infuse large quantities of solution in the initial treatment of Podostroma cornu-damae poisoning, and blood purification therapy (CHDF and PE) may be highly recommended.
Suzuki
Masayuki
M
Department of Internal Medicine, Yamagata Prefectural Central Hospital.
Katoh
Yoshinobu
Y
Kumagai
Hiroaki
H
Saitoh
Mikio
M
Ishikawa
Hiroyasu
H
Itoh
Hiroshi
H
Shimazu
Kenichi
K
D005440:Fluid Therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D017583:Hemodiafiltration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000628:therapy*; D010951:Plasma Exchange; D016896:Treatment Outcome
D016179:Granulocyte Colony-Stimulating Factor