title: [Four cases of deadly intoxication by Lepiota brunneoincarnata].
abstract: We report the case of a collective intoxication by ingestion of a mushroom "Lepiota brunneoincarnata" at the origin of the death of four members of the same family aged between 3 and 15 year old. We discuss the physiopathology and the prognosis factors of such intoxications through these four observations which highlight the clinical signs, biological disturbances due to the intoxication, autopsy and histology findings. The first observation concerns a six year old girl. She presented an abdominal pain with vomiting and aqueous diarrhea. She died during the early phase of the intoxication (seven hour after the ingestion of the mushroom), death was secondary to an acute dehydration. The three other observations concern children aged between three and fifteen year old. They presented typical phalloïdian syndrome symptoms evolution with first gastro-intestinal and then hepatic signs. They died after a period varying between three and eleven days without being able to profit from a hepatic transplantation. The autopsy findings showed the presence of an important cerebral edema and hemorrhagic zones of the liver in all the cases, the presence of hemorrhagic complications in two cases. Histology investigations showed the presence of a diffuse centrilobular and periportals necrosis.
authors.affiliation: Service de médecine légale, Hôpital Charles-Nicolle, Tunis, Tunisia. benkhelilmehdi@yahoo.fr
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ben Khelil
authors.forename: Mongi
authors.initials: M
authors.lastname: Zhioua
authors.forename: Olfa
authors.initials: O
authors.lastname: Bakir
authors.forename: Mohamed
authors.initials: M
authors.lastname: Allouche
authors.forename: Fatme
authors.initials: F
authors.lastname: Gloulou
authors.forename: Ahmed
authors.initials: A
authors.lastname: Banasr
authors.forename: Slim
authors.initials: S
authors.lastname: Haouet
authors.forename: Abdelrazzek
authors.initials: A
authors.lastname: Hedhili
authors.forename: Moncef
authors.initials: M
authors.lastname: Hamdoun
mesh_terms: D000293:Adolescent; D001344:Autopsy; D002648:Child; D002675:Child, Preschool; D005190:Family; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D009145:Mushroom Poisoning / Q000401:mortality / Q000473:pathology*; D009336:Necrosis