Disulfiramlike Mushroom Toxicity Workup

Updated: Apr 20, 2015
  • Author: C Crawford Mechem, MD, MS, FACEP; Chief Editor: Asim Tarabar, MD  more...
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Laboratory Studies

The extent of diagnostic testing is guided by the patient's clinical presentation. Appropriate laboratory studies may include the following:

  • Electrolytes, BUN, creatinine levels (assess for dehydration and electrolyte abnormalities)
  • Serum ethanol levels (may be of value to determine if more acetaldehyde formation and progression of toxicity can be expected)
  • No clinical role for determination of acetaldehyde concentrations

Other Tests

See the list below:

  • Obtaining an ECG in patients with chest pain would be prudent. A recent case report described a 22-year-old chronic alcoholic male on disulfiram who consumed alcohol and then developed anginal symptoms. [5] ECG changes were consistent with an inferior wall myocardial infarction (MI). He underwent coronary angiography, which revealed clean vessels, and his MI was attributed to vasospasm.
  • Mycologist may positively identify mushroom species involved; however, unlike Amanita phalloides, positive identification of coprine-containing mushrooms rarely contributes to diagnosis or alters management.