Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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An Elderly Man with Fatal Respiratory Failure after Eating a Poisonous Mushroom Podostroma cornu-damae

  • Jang, Juah (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Cheol-Hong (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Yoo, Jun Jae (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Mi Kang (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Jae Eun (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lim, Ah Leum (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Choi, Jeong-Hee (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Hyun, In Gyu (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Shim, Jung Weon (Department of Pathology, Hallym University College of Medicine) ;
  • Shin, Ho-Seung (Department of Thoracic and Cardiovascular Surgery, Hallym University College of Medicine) ;
  • Han, Joungho (Department of Pathology, Sungkyunkwan University School of Medicine) ;
  • Seok, Soon Ja (Agricultural Microbiology Department, National Academy of Agricultural Science, Rural Development Administration)
  • Received : 2013.06.12
  • Accepted : 2013.09.13
  • Published : 2013.12.30
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Abstract

A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea.

Keywords

References

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