JIST

Abstract

Mushroom poisoning is frequently reported from different geographical locations. Due to high case fatality rate, it is considered as a medical emergency and is seen among communities with the habit of hunting and cooking its wild variety. Amongst all identified species, poisoning caused by Amanita Phalloides is considered to be the fatal one because of onset of late symptoms with hepato-renal toxicity and persistence of toxins even after cooking or freezing. Symptoms appear usually after 6-8 hours of ingestion and by the time patient is brought to the emergency department, early hepatic complication already develops.

In Assam, there has been increasing incidences of toxicity following poisonous mushroom ingestion since last few years. In the year 2008, a significant number of cases of mushroom poisoning were reported from few districts of upper Assam. In two separate incidences, eight victims of wild mushroom poisoning were admitted at tertiary care institute of Dibrugarh district of Assam during the month of April, 2014. All of them died within a period of 7 days. Autopsy was conducted in department of Forensic Medicine of the same institute. Out of eight deceased, five were male adult and two children of age below 12 years. Autopsy findings were suggestive of fulminant hepatic and renal failure and their complications in all cases. Present case series focuses on fatalities due to poisonous mushroom in respect to their clinical presentation, laboratory investigation and autopsy findings.

Conclusion: Pesticides, especially cholinergic pesticides were the commonest group of agents used for deliberate self-poisoning in the study. There was a reduction in overall mortality each year due to self-poisoning over the study period with a reduction in pesticide related admissions each year. Regulation of pesticide use should be considered while planning prevention strategies of suicide.