Treatment of Mushroom Poisoning

Abstract

To the Editor.— The survey on mushroom poisoning by Hanrahan and Gordon 1 published inThe Journalcovered four types of toxic mushrooms, each illustrated by a clinical case. However, the section on amatoxin poisoning (caused by either Amanita phalloides, Amanita virosa , or Amanita verna ) contains inaccuracies and fails to inform the reader about advances in therapy. The statement that the mortality of amatoxin poisoning was until recently 50% to 90% is misleading and likely to falsify the interpretation of therapeutic results. In a large study including 288 cases of Amanita ("death cap") intoxications observed between 1919 and 1958 in Switzerland, the mortality rate was 30%. 2 In much smaller series of patients, a higher mortality may be occasionally recorded, but it is clear that large series are mandatory to assess the mortality rate correctly. In a newer series of 205 cases of Amanita intoxications that occurred in Europe from