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Poisoning due to raw Gyromitra esculenta (false morels) west of the Rockies

Published online by Cambridge University Press:  21 May 2015

Anne M. Leathem*
Affiliation:
BC Drug and Poison Information Centre, University of British Columbia, Vancouver, BC
Thomas J. Dorran
Affiliation:
Department of Emergency Medicine, Nanaimo Regional General Hospital, Nanaimo, BC and Clinical Innovation and Integration, B.C. Ministry of Health, Victoria, BC

Abstract

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Vomiting with abdominal pain is a common presentation in the emergency department (ED). Without a careful history, unusual causes, such as toxic ingestion, may evade diagnosis. We report a case of an Asian couple who presented to the ED with vomiting and epigastric distress. They were discharged with no definite diagnosis, but on a return ED visit the following day were diagnosed with toxic ingestion of Gyromitra esculenta, commonly known as the western false morel. The patients were admitted and treated with intravenous hydration and pyridoxine. Both patients developed mild hepatotoxicity but went on to fully recover. This case demonstrates that the western false morel may cause significant toxicity and it highlights the importance of obtaining a complete history in patients who present with non-specific gastrointestinal symptoms.

Type
Case Reports • Observations de cas
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

References

1.Benjamin, DR. Mushrooms: Poisons and Panaceas. A Handbook for Naturalists, Mycologists, and Physicians. New York (NY): WH Freeman and Co; 1995. p. 264–82.Google Scholar
2.Giusti, GV, Carnevale, A. A case of fatal poisoning by Gyromitra esculenta. Arch Toxicol 1974;33:4954.Google Scholar
3.Berger, KJ, Guss, DA. Mycotoxins revisited: part II. J Emerg Med 2005;28:175–83.CrossRefGoogle ScholarPubMed
4.Beug, MW, Shaw, M, Cochran, KW. Thirty years plus of mushroom poisoning: summary of the approximately 2,000 reports in the NAMA case registry. McIlvainea [Forthcoming].Google Scholar
5.Balterowich, L, Blaney, B, White, S, et al. Acute hepatotoxicity following ingestion of Gyromitra esculenta (false morel) mushrooms [abstract]. J Toxicol Clin Toxicol 1996;34:602.Google Scholar
6.McKenny, M, Stuntz, DE. The New Savory Wild Mushroom. 3rd ed. Seattle (WA): University of Washington Press; 1987. p. 202–5.Google Scholar
7.Spoerke, DG, Rumack, BH. Handbook of mushroom poisoning. Diagnosis and Treatment. Boca Raton (CA):CRC Press; 1994.p. 279–87.Google Scholar
8.Michelot, D, Toth, B. Poisoning by Gyromitra esculenta-a review. J Appl Toxicol 1991;11:235–43.Google Scholar
9.Karlson-Stiber, C, Persson, H. Cytotoxic fungi-an overview. Toxicon 2003;42:339–49.Google Scholar
10.Pyysalo, H, Niskanen, A. On the occurrence of N-methyl-N-formylhydrazones in fresh and processed False Morel, Gyromitra esculenta. J Agric Food Chem 1977;25:644–7.CrossRefGoogle ScholarPubMed
11.Diaz, JH. Syndromic diagnosis and management of confirmed mushroom poisoning. Crit Care Med 2005;33:427–36.CrossRefGoogle Scholar
12.Schonwald, S.Mushrooms in: Dart RC (Ed). Medical Toxicology. 3rd ed. New York (NY): Lippincot Williams & Wilkins; 2004.Google Scholar
13.Toth, B, Patil, K, Pyysalo, H, et al. Cancer induction in mice by feeding the raw false morel mushroom-Gyromitra esculenta. Cancer Res 1992;52:2279–84.Google ScholarPubMed
14.Sterman, MB, Kovalesky, RA. Anticonvulsant effects of restraint and pyridoxine on hydrazine seizures in the monkey. Exp Neurol 1979;65:7886.CrossRefGoogle ScholarPubMed
15.Pacioni, G.Simon and Shuster’s Guide to Mushrooms. Lincoff, Gary (ed). New York (NY): Simon & Shuster; 1981.Google Scholar
16.Phillips, R.Mushrooms of North America. 1st ed. London (UK): Little, Brown & Co; 1991.Google Scholar
17.Lincoff, G. National Audubon Society Field Guide to North American Mushrooms. 1st ed. New York (NY): Alfred A Knopf Inc; 1995.Google Scholar
18.Evergreen State College. Mushrooms. Available: http://www.evergreen.edu/mushrooms (accessed 2006 Aug 21).Google Scholar
19.MycoWeb. Mushrooms, fungi, mycology. Available: http://www.mycoweb.com (accessed 2006 Aug 21).Google Scholar
20.Fungi, Tom Volk’s. Available: http://www.tomvolkfungi.net (accessed 2006 Aug 21).Google Scholar
21.Kent, DA, Willis, GA, eds. Poison Management Manual. 4th ed. Vancouver (BC): BC Drug and Poison Information Centre; 1997. p. 364–6.Google Scholar