title: The outcome of North American pediatric unintentional mushroom ingestions with various decontamination treatments: an analysis of 14 years of TESS data.
abstract: The optimum empiric decontamination therapy for unintentional pediatric mushroom ingestion is not known. We sought to determine case outcomes for unintentional mushroom ingestions in children by decontamination therapies utilized. The 1992-2005 American Association of Poison Control Centers Toxic Exposure Surveillance System was queried for cases of unintentional acute mushroom ingestions in children age <6 years. Cases were excluded if outcome was unknown, if exposure was coded as unrelated to the symptoms, or if there was co-ingestion of a non-mycoid substance. The treatment subgroups analyzed were ipecac, single-dose activated charcoal, and no gastric decontamination. 82,330 cases met the inclusion criteria with 22,454 cases excluded. There were 16 cases with major effects and no deaths. There were 57,531 cases in the three treatment subgroups. There was a significantly smaller percentage of cases with moderate or major outcomes in the ipecac subgroup compared to the no decontamination subgroup. There was a significantly greater percentage of cases with moderate or major outcomes in the activated charcoal compared to the no decontamination subgroup. If decontamination therapy is being performed, and this data suggests it may not be necessary, syrup of ipecac could still be considered an effective option.
authors.affiliation: Carolinas Poison Center, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC, USA. michael.beuhler@carolinashealthcare.org
authors.forename: M C
authors.initials: MC
authors.lastname: Beuhler
authors.forename: H C
authors.initials: HC
authors.lastname: Sasser
authors.forename: W A
authors.initials: WA
authors.lastname: Watson
mesh_terms: D000931:Antidotes / Q000627:therapeutic use; D002606:Charcoal / Q000627:therapeutic use; D002675:Child, Preschool; D016208:Databases, Factual; D004639:Emetics / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007486:Ipecac / Q000627:therapeutic use; D009145:Mushroom Poisoning / Q000188:drug therapy* / Q000453:epidemiology*; D009656:North America / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000931:Antidotes; D004639:Emetics; D002606:Charcoal; D007486:Ipecac