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Gyromitra Mushroom Toxicity Follow-up

  • Author: Reed Brozen, MD; Chief Editor: Asim Tarabar, MD  more...
 
Updated: Apr 14, 2015
 

Further Outpatient Care

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  • Patients with gyromitrin ingestion who seek medical care, are asymptomatic 8 hours after ingestion, and are without clinical or laboratory signs of toxicity may be considered for discharge.
    • Early follow-up care for reevaluation must be in place at the time of discharge. Instruct patients to return immediately if they become symptomatic.
    • Instruct patients to keep themselves well hydrated.
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Further Inpatient Care

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  • Admit all symptomatic patients in whom gyromitrin poisoning is suspected for further management and monitoring.
  • Monitor patients for dehydration, neurologic toxicity, and liver or renal failure.
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Transfer

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  • Consider patients who have developed seizures, coma, severe methemoglobinemia, or hemolysis for intensive care unit admission.
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Complications

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  • Aspiration pneumonia
  • Rhabdomyolysis
  • Renal failure secondary to hemolysis and rhabdomyolysis
  • Liver failure
  • Anoxic and hepatic encephalopathy
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Prognosis

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  • Most patients fully recover after 2-5 days of a gastric illness.
  • Death from Gyromitra species is rare in North America.
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Patient Education

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Contributor Information and Disclosures
Author

Reed Brozen, MD Director of Air Transport, Associate Professor, Department of Emergency Medicine, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center

Reed Brozen, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, New Hampshire Medical Society, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Marcus J Hampers, MD, MBA Instructor, Department of Medicine, Dartmouth Medical School; Consulting Staff, Department of Internal Medicine, Section of Hospital Medicine, Department of Anesthesiology, Section of Critical Care Medicine, and Department of Emergency Medicine, Dartmouth Hitchcock Medical Center

Marcus J Hampers, MD, MBA is a member of the following medical societies: American Medical Association, New Hampshire Medical Society, Society of Critical Care Medicine, Undersea and Hyperbaric Medical Society, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and St Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Additional Contributors

B Zane Horowitz, MD, FACMT Professor, Department of Emergency Medicine, Oregon Health and Sciences University School of Medicine; Medical Director, Oregon Poison Center; Medical Director, Alaska Poison Control System

B Zane Horowitz, MD, FACMT is a member of the following medical societies: American College of Medical Toxicology

Disclosure: Nothing to disclose.

Acknowledgements

Michael Hodgman, MD Assistant Clinical Professor of Medicine, Department of Emergency Medicine, Bassett Healthcare

Michael Hodgman, MD is a member of the following medical societies: American College of Medical Toxicology, American College of Physicians, Medical Society of the State of New York, and Wilderness Medical Society

Disclosure: Nothing to disclose.

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