Scenario of mushroom poisoning in a tertiary care hospital.

Introduction: Mushroom poisoning is not new to Nepal. Undocumented and unrecorded mushroom poisoning is more common than the published one. We evaluated the pattern and outcomes following toxic mushroom ingestions.
Methods: We did a retrospective analysis of patients admitted with mushroom poisoning in BPKIHS, a tertiary care hospital in Nepal, from 2002 to 2006. The diagnosis of mushroom poisoning was based on history and clinical presentation.
Results: Twenty seven patients, aged between 7-83 years were studied. Fourteen (51.86%) were male and 13 (48.14%) were female. All (100%) patients had consumed wild mushroom unintentionally. Twelve patients developed symptoms within first hour and 11 patients within one to six hours. The average delay in presenting to our hospital was 23.1 (2-96) hours. In 10 cases, other family members were affected, out of which in two cases the family members had died in other hospitals. Reported symptoms were nausea 27 (100%), vomiting 24 (88.88%), abdominal cramping 8 (29.6%), jaundice 3 (11.1%), diarrhea 17 (62.96%) and altered sensorium in 8 patients (29.65%). All patients were treated conservatively. Three patients with severe hepatitis were admitted in ICU, out of which two recovered without liver transplant. One eight year old boy developed acute liver failure and expired within 24 hours of hospitalization.
Conclusions: Most of the mushroom poisoning was acute, unintentional and by consumption of wild mushroom. Community based awareness programs will help prevent the instances of poisoning.