Disulfiramlike Mushroom Toxicity Workup

Updated: Apr 08, 2019
  • Author: Stephen L Thornton, MD; Chief Editor: Sage W Wiener, MD  more...
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Workup

Laboratory Studies

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

  • Electrolytes, blood urea nitrogen (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

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Other Tests

Obtaining an electrocardiogram (ECG) in patients with chest pain would be prudent. One case report described a 22-year-old chronic alcoholic male on disulfiram who consumed alcohol and then developed anginal symptoms. [12] 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.

A mycologist may positively identify the mushroom species involved. However, unlike identification of Amanita phalloides, positive identification of coprine-containing mushrooms rarely contributes to diagnosis or alters management.

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