title: Mushroom poisoning in Hong Kong: a ten-year review.
abstract: BACKGROUND
  Mushroom poisoning is a cause of major mortality and morbidity all over the world. Although Hong Kong people consume a lot of mushrooms, there are only a few clinical studies and reviews of local mushroom poisoning. This study aimed to review the clinical characteristics, source, and outcome of mushroom poisoning incidences in Hong Kong.
  
  
  METHODS
  This descriptive case series review was conducted by the Hong Kong Poison Information Centre and involved all cases of mushroom poisoning reported to the Centre from 1 July 2005 to 30 June 2015.
  
  
  RESULTS
  Overall, 67 cases of mushroom poisoning were reported. Of these, 60 (90%) cases presented with gastrointestinal symptoms of vomiting, diarrhoea, and abdominal pain. Gastrointestinal symptoms were early onset (<6 hours post-ingestion) and not severe in 53 patients and all recovered after symptomatic treatment and a short duration of hospital care. Gastrointestinal symptoms, however, were of late onset (≥6 hours post-ingestion) in seven patients; these were life-threatening cases of amatoxin poisoning. In all cases, the poisonous mushroom had been picked from the wild. Three cases were imported from other countries, and four collected and consumed the amatoxin-containing mushrooms in Hong Kong. Of the seven cases of amatoxin poisoning, six were critically ill, of whom one died and two required liver transplantation. There was one confirmed case of hallucinogenic mushroom poisoning caused by Tylopilus nigerrimus after consumption of a commercial mushroom product. A number of poisoning incidences involved the consumption of wild-harvested dried porcini purchased in the market.
  
  
  CONCLUSIONS
  Most cases of mushroom poisoning in Hong Kong presented with gastrointestinal symptoms and followed a benign course. Life-threatening cases of amatoxin poisoning are occasionally seen. Doctors should consider this diagnosis in patients who present with gastrointestinal symptoms that begin 6 hours or more after mushroom consumption.
authors.affiliation: Hong Kong Poison Information Centre, United Christian Hospital, Kwun Tong, Hong Kong.
authors.forename: C K
authors.initials: CK
authors.lastname: Chan
authors.affiliation: Hong Kong Poison Information Centre, United Christian Hospital, Kwun Tong, Hong Kong.
authors.forename: H C
authors.initials: HC
authors.lastname: Lam
authors.affiliation: School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: S W
authors.initials: SW
authors.lastname: Chiu
authors.affiliation: Hong Kong Poison Information Centre, United Christian Hospital, Kwun Tong, Hong Kong.
authors.forename: M L
authors.initials: ML
authors.lastname: Tse
authors.affiliation: Hong Kong Poison Information Centre, United Christian Hospital, Kwun Tong, Hong Kong.
authors.forename: F L
authors.initials: FL
authors.lastname: Lau
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000546:Amanitins / Q000506:poisoning*; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009145:Mushroom Poisoning / Q000453:epidemiology*; D012189:Retrospective Studies; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
chemical_list: D000546:Amanitins; C018207:amatoxin
keywords: Amanitins/poisoning; Irritable bowel syndrome; Mushroom poisoning