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Paper II — 2015 September (Supplementary) (2010 Scheme) — Q10

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Paper II
2015 September (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Mycotic poisoning

Q102 marksShort Notes

Answer

Mycotic poisoning (mycetism/mushroom poisoning) refers to the toxic syndrome following ingestion of poisonous wild mushrooms, with clinical severity varying according to the specific toxin(s) present in the ingested species.

Classification by onset:

  • Rapid-onset (within 2 hours) — generally causes milder, self-limiting gastrointestinal or neurological symptoms (e.g., muscarine-containing species causing a cholinergic syndrome).
  • Delayed-onset (6–24 hours or later) — the more dangerous category, classically associated with Amanita phalloides (“death cap”) containing amatoxins, which inhibit RNA polymerase II, causing a biphasic illness: initial gastrointestinal symptoms, apparent improvement, then progressive, often fatal fulminant hepatic and renal failure.

Clinical significance: the delayed-onset pattern is critical — apparent improvement after initial symptoms can mask progression toward severe hepatotoxicity.

Management: largely supportive; specific measures for amatoxin poisoning include silibinin, N-acetylcysteine, and, in severe cases, liver transplantation.

  1. 1General Parasitology

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