Abstract：
Wild mushroom poisoning is a global public health concern, with mushrooms containing amatoxins being the main cause of fatalities. Mushrooms from the genus Amanita and Galerina contain amatoxins. Here we present a case of wild mushroom poisoning that affected three individuals, resulting in two fatalities. Within 10-15 hours after consumption, they experienced symptoms of gastroenteritis such as vomiting, abdominal pain, and diarrhea. One individual sought medical attention promptly and recovered, while the other two sought medical help nearly two or three days after the onset of symptoms, by which time their conditions had already worsened and led to their deaths. The mushrooms were identified belonging to genus Galerina, and laboratory test revealed variations in toxin levels among mushrooms collected from different parts of the decaying stump. The higher levels of α-amanitin, β-amanitin, and γ-amanitin were detected near the base of the tree stump, but trace levels of α-amanitin were found near the top of the stump, while β-amanitin and γ-amanitin were undetectable. This case emphasizes the importance of seeking immediate medical attention when experiencing delayed-onset gastrointestinal symptoms, as it may indicate more severe mushroom poisoning, particularly amatoxin poisoning. Timely and appropriate treatment is equally important. Additionally, consuming different units of the mushrooms in the same incident can lead to varying prognoses due to differences in toxin levels.
摘要：
野生蘑菇中毒是全球公共卫生问题，含有阿马毒素的蘑菇是死亡的主要原因。Amanita和Galerina属的蘑菇含有阿马毒素。这里我们介绍了一个野生蘑菇中毒的案例，影响了三个人，导致两人死亡。食用后10-15小时内，他们出现了胃肠炎的症状，如呕吐，腹痛,和腹泻。一名人员迅速寻求医疗护理并康复，而另外两人在症状出现近两三天后寻求医疗帮助，到那时，他们的状况已经恶化并导致他们死亡。这些蘑菇被鉴定为Galerina属，实验室测试显示，从腐烂的残端不同部位收集的蘑菇中的毒素水平存在差异。较高水平的α-amanitin,β-amanitin,在树桩底部附近检测到γ-amanitin，但是在树桩顶部附近发现了微量的α-amanitin，而β-amanitin和γ-amanitin检测不到。该病例强调了在出现延迟发作的胃肠道症状时立即就医的重要性，因为这可能表明更严重的蘑菇中毒，尤其是amatoxin中毒.及时和适当的治疗同样重要。此外,在同一事件中食用不同单位的蘑菇会由于毒素水平的差异而导致不同的预后。
