Increasing incidence of mycotoxicosis in South-Eastern Germany: a comprehensive analysis of mushroom poisonings at a University Medical Center

Summary

This study examined mushroom poisoning cases in a German hospital from 2005 to 2022 and found that poisonings have nearly doubled in recent years, likely due to more people foraging for wild mushrooms and changes in climate affecting mushroom distribution. The death cap mushroom (Amanita phalloides) caused the majority of serious cases, leading to liver and kidney failure. Researchers found that a blood-cleansing treatment called plasmapheresis could help stabilize patients with life-threatening bleeding complications while they recovered or waited for a liver transplant.

Background

Mushroom poisoning poses significant clinical challenges due to difficulty in identifying consumed species and the potentially fatal toxins they contain. Climate change is affecting the distribution and proliferation of mushroom species, potentially increasing exposure to toxic varieties. The risk of severe poisoning, particularly from Amanita phalloides, can result in acute liver and kidney failure with limited therapeutic options available.

Objective

This study aimed to assess trends and treatment outcomes of mushroom poisoning cases from 2005 to 2022 at a University Medical Center in South-Eastern Germany. The research focused on identifying mushroom varieties involved, examining cases with liver damage, and exploring the impact of climate change on poisoning incidence. The study specifically investigated the potential utility of plasmapheresis as a treatment intervention for severe cases.

Results

Incidence nearly doubled in the past nine years compared to the first eight years of the study period. Nine distinct mushroom species were identified, with Amanita phalloides comprising 44.2% of cases. Seasonal patterns remained consistent between August and November. Plasmapheresis effectively stabilized coagulation parameters and served as a bridge to recovery or liver transplantation in severe cases with coagulopathy.

Conclusion

Rising mushroom poisonings are attributed to increased nature-based leisure activities and climate change effects on fungal distribution. Healthcare professionals must maintain heightened vigilance during mushroom season. Plasmapheresis shows promise as an effective intervention for managing acute liver failure with coagulopathy, potentially serving as a bridge to recovery or transplantation.
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