Investigation and analysis of 102 mushroom poisoning cases in Southern China from 1994 to 2012

Mushroom poisoning is the main cause of mortality in food poisoning incidents in China. Although some responsible mushroom species have been identified, some were identified inaccuratly. This study investigated and analyzed 102 mushroom poisoning cases in southern China from 1994 to 2012, which involved 852 patients and 183 deaths, with an overall mortality of 21.48 %. The results showed that 85.3 % of poisoning cases occurred from June to September, and involved 16 species of poisonous mushroom: Amanita species (A. fuliginea, A. exitialis, A. subjunquillea var. alba, A. cf. pseudoporphyria, A. kotohiraensis, A. neoovoidea, A. gymnopus), Galerina sulciceps, Psilocybe samuiensis, Russula subnigricans, R. senecis, R. japonica, Chlorophyllum molybdites, Paxillus involutus, Leucocoprinus cepaestipes and Pulveroboletus ravenelii. Six species (A. subjunquillea var. alba, A. cf. pseudoporphyria, A. gymnopus, R. japonica, Psilocybe samuiensis and Paxillus involutus) are reported for the first time in poisoning reports from China. Psilocybe samuiensis is a newly recorded species in China. The genus Amanita was responsible for 70.49 % of fatalities; the main lethal species were A. fuliginea and A. exitialis. Russula subnigricans caused 24.59 % of fatalities, and five species showed mortality > 20 % (A. fuliginea, A. exitialis, A. subjunquillea var. alba, R. subnigricans and Paxillus involutus). Mushroom poisoning symptoms were classified from among the reported clinical symptoms. Seven types of mushroom poisoning symptoms were identified for clinical diagnosis and treatment in China, including gastroenteritis, acute liver failure, acute renal failure, psychoneurological disorder, hemolysis, rhabdomyolysis and photosensitive dermatitis.