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Fatal Mushroom Poisoning in Syrian Refugees

Semih Petekkaya, Turgay Börk, Nusret Ayaz, Cihan Göktürk, Emine Şamdancı, Osman Celbiş.

Abstract
Objective:
The aim of this study was to evaluate the deaths of Syrian refugees caused by mushroom poisoning in the light of patient data, living conditions and autopsy findings.
Methods:
An evaluation was made of 6 Syrian refugees who died at Malatya Turgut Ozal Medical Centre as a result of mushroom poisoning in 2014. Diagnosis of mushroom poisoning was made from the anamnesis, laboratory test results and clinical evaluation of the patients. The autopsy procedures for all the cases were performed at the Malatya Local Authority Forensic Medicine Institution. All the cases were evaluated in respect of age, gender, height, weight, symptoms of poisoning, duration of hospitalization, month of poisoning, laboratory parameters, autopsy findings and histopathological findings.
Results:
The 6 cases included in the study comprised 4 males and 2 females with a mean age of 27±18.7 years. Some of the cases were related. It was determined that all the cases were poisoned after eating wild mushrooms that they had collected. In all the cases, the liver function tests were impaired, with values determined of mean ALT 5456.83±2556.47 U/L, AST 2517.66±2351.56 U/L, INR 5.04±2.04 and ammoniac 904.16±308.6 µg/dl. In the autopsy, widespread foci of bleeding were determined in the internal organs, a jaundiced appearance and fluid accumulation in the body cavities (pleural effusion and acid). Thrombosis in the vena porta hepatica was determined in 1 case. In the histopathological examination, massive liver necrosis was seen in all the cases.


Conclusion:
Mushroom poisoning as a definitive cause of death must be determined with a detailed history, autopsy findings and histopathology together. Furthermore, refugees should be warned that there could be similar species of mushrooms growing in different natural environments and that they could be poisonous.

Key words: mushroom poisoning, organ transplant, death, autopsy



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