title: Mushroom poisoning in children: clinical presentation and outcome.
abstract: BACKGROUND
  A variable clinical picture characterizes mushroom poisoning. The Amatoxin, the main toxic component of these fungi, are responsible for gastrointestinal symptoms as well as hepatic and renal failure. As acute gastroenteritis is extremely common in our set up, so every patient presenting with these symptoms is treated as gastroenteritis of viral aetiology. The authors present the clinical picture of the phalloid syndrome, its treatment and immediate outcome.
  
  
  METHODS
  All children age less than 16 years admitted in Saidu Hospital Swat from January to December 2006 with mushroom poisoning were included in the study. Patients with doubtful history or with associated illness were not included. The diagnosis was based on the clinical picture of the patient, history and the laboratory data. In addition to maintenance of fluid and electrolyte balance and treating sepsis, oral Silymarin and intravenous penicillin was started. Liver function tests, renal functions tests, serum electrolytes and coagulation profile was done in all the patients. The severity of poisoning was graded according to hepatic transaminase elevations and prolongation of prothrombin time.
  
  
  RESULTS
  Of the 18 patients, fifteen were above five years of age. Female were twice in number. Fifteen patients developed hepatic failure and three patients developed renal failure. Thirteen patients expired.
  
  
  CONCLUSIONS
  To start timely management, Mushroom poisoning should be considered in the differential diagnosis in patients presenting with food poisoning particularly coming in groups. Delay in diagnosis is associated with high mortality.
authors.affiliation: Department of Child Health, Saidu Teaching, Hospital, Swat, Pakistan. alijan56@hotmail.com
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Jan
authors.forename: Tahir Saeed
authors.initials: TS
authors.lastname: Siddiqui
authors.forename: Nasir
authors.initials: N
authors.lastname: Ahmed
authors.forename: Israr
authors.initials: I
authors.lastname: Ul Haq
authors.forename: Ziaullah
authors.initials: Z
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000545:Amanita / Q000737:chemistry; D000546:Amanitins / Q000506:poisoning; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D007223:Infant; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D009145:Mushroom Poisoning / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D010154:Pakistan / Q000453:epidemiology; D010949:Plasma; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000546:Amanitins; C018207:amatoxin