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Poisoning with death cup amanita phalloides ap

, : Poisoning with death cup amanita phalloides ap. Ugeskrift for Laeger 150(16): 975-978

The hitherto most extensive documented Death Cap accident in Denmark which involved 11 immigrants and tourists from Thailand is described. Death Cap poisoning is a variegated multi-organ syndrome, characterized mainly by gastro-intestinal symptoms and hepatotoxicity. All 11 patients had gastro-intestinal symptoms, nine had severe liver damage, seven had severe metabolic acidosis, six had electrocardiographic changes, six had pancreatic involvement, three had prerenal uraemia, one had evidence of skeletal muscle involvement and one had signs of bone-marrow suppression. One patient died in hepatic coma. The therapeutic regime was as suggested by Faulstich and comprized gastric lavage, forced diuresis, cortisol and penicillin in massive doses, silibinin, instillation of charcoal and aspiration via a duodenal tube. The mortality observed here of 9% is comparable to that found in more extensive investigations abroad. None of the surviving patients showed signs of permanent injury on follow-up examination. The treatment is based on animal experiments but on account of great inter-species differences involving inter alii the absorption of toxins, the relevance in man may be questioned.

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