1. WILD MUSHROOM POISONING. A CASE REPORT CHRIS NTIAKALIS, ILKER MEMET, EVANTHIA TSALKIDOU ICU GENERAL HOSPITAL OF KOMOTINI

2. Augmentation of severe cases of wild mushroom poisoning in Northern Greece Better treated in ICU settings due to vast implications in renal, hepatic and hematopoietic system. Anatoxins of sp. Amanita Phalloides, Galerina, Lepiota the main reason of severity

3. Male pt 78 years old intoxicated by Amanita Galerina treated in our department. Signs and symptoms: Excessive diarrhea and vomiting 12 hours after ingestion Signs of hypovolemic shock Stupor, GCS=9

4. LABORATORY MEASUREMENTS DAY 1DAY 4 Creatinine3mg/dl6,9mg/dl SGOT1504 IU/L6099 IU/L SGPT890 IU/L5787 IU/L Total Bilirubin2,7mg/dL22,2mg/Dl Alkaline Phosphatase64 IU/L67 IU/L Amylase serum1464 IU/L755 IU/L INR2,138,72

5. THERAPEUTIC APPROACHES Non invasive ventilation for 10 days Immediate and constant hemoperfusion for 8 days Administration of fluids and charcoal every 2 hours the first 2 days Penicillin G i.v in dosage 500.000-1.000.000 i.v/Kg/d for 4 days Semitidine, silibinin (Legalon) and FFP

6. CONCLUSIONS No secure rule of “safe” wild musrhoom recognition Better treatment in ICU Last therapeutical approach liver transplantation

7. REFERENCES 1.Diaz, JH. “ Evolving global epidemiology, syndromic classification, general management and prevention of unknown mushroom poisonings”Crit. Med. 2005:33, pp.419-426 2.Ganzert M., Felgenhauer N., Zilker T., “ Indication of liver transplantation following amatoxin intoxication”, Hepatol, Feb 2005, 42 (2), p.202-209 3.Mavromatides Constantinos, “Kidney and poisoning”, 2007, Vol. B, pp. 7-9