OBJECTIVEThe objective of this study was to present special clinical and laboratory features of 294 cases of mushroom poisoning.MATERIALS AND METHODSIn this retrospective study, 294 patients admitted to the Pediatric and Adult Emergency, Internal Medicine and ICU Departments of Cumhuriyet University Hospital were investigated.RESULTSOf 294 patients between the ages of 3 and 72 (28.97 ± 19.32), 173 were female, 121 were male and 90 were under the age of 16 years. One hundred seventy-three patients (58.8%) had consumed the mushrooms in the early summer. The onset of mushroom toxicity symptoms was divided into early (within 6 h after ingestion) and delayed (6 h to 20 d). Two hundred eighty-eight patients (97.9%) and six (2.1%) patients had early and delayed toxicity symptoms, respectively. The onset of symptoms was within two hours for 101 patients (34.3%). The most common first-noticed symptoms were in the gastrointestinal system. The patients were discharged within one to ten days. Three patients suffering from poisoning caused by wild mushrooms died from fulminant hepatic failure.CONCLUSIONEducation of the public about the consumption of mushrooms and education of health personnel working in health centers regarding early treatment and transfer to hospitals with appropriate facilities are important for decreasing the mortality.

BackgroundMercury poisoning can occur as a result of occupational hazard or suicide attempt. This article presents a 36-year-old case admitted to emergency department (ED) due to exposure to metallic mercury.Case PresentatıonA 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school. She had put it on the heating stove. One day later, her 14-month old sister baby got fever and died before admission to the hospital. Her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and regular; respiration, 18 bpm; O2 saturation, 96%. Nothing was remarkable on examination and routine laboratory tests. As serine or urinary mercury levels could not be tested in the city, symptomatic chelation treatment with N-acetyl cysteine (NAC) was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without any sequelae or complaint. At the discharge day blood was drawn and sent for mercury levels which turned out to be 30 μg/dL (normal range: 0 - 10 μg/dL).ConclusionPublic education on poisoning and the potential hazards of mercury are of vital importance for community health.

BackgroundSplenic artery aneurysms (SAA) are uncommon but the most common visceral artery aneurysm. Splenic artery aneurysms are important to recognize because up to 25% may be complicated by rupture and the mortality rate after rupture is between 25% and 70%.Case reportWe present a patient who have abdominal pain. Previously healthy 22-year-old female admitted to emergency department with abdominal pain. Her physical examination reveals only left upper quadrant tenderness. Suddenly she developed hypovolemic shock. On emergent laparotomy massive blood collection within peritoneal cavity and retroperitoneal space at the left upper quadrant was detected. The source of bleeding was evident as rupture of splenic artery aneurysm. Splenectomy was performed following the ligation of splenic artery proximal to lesion. On the tenth day she was discharged from the hospital with complete recovery.ConclusionIt is important to remember rupture of splenic artery aneurysm in patients with abdominal pain and hypovolemic shock status.

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Acute pharyngitis in adultsis primaril y a viralinfection;only about 10% of cases are of bacterial etiology. Most casesof bacterialpharyngitisarecaused bygroupA betahemolyticstreptococci(GABHS). Onelaboratory method for the diagnosis of GABHS is rapid antigen diagnostic testing (RADT), which can beprocessed duringan emergency department visit and which has become a popular alternative to throatswabcultures. Weconducted a study to define the sensitivity and specificity of RADT, using throat culture results as the gold standard, in 100emergency department patientswhopresented with symptoms consistent with streptococcal pharyngitis. Wefound that RADT had a sensitivityof 68.2% (15 of 22), a specificity of89.7% (70 of78), a positivepredictive value of 65.2% (15 of23), and a negative predictivevalueof90. 9% (70 of77). We conclude that RADT isusefulin theemergency departmentwhen theclinical suspicion isGABHS, but resultsshouldbeconfirmed with a throatculturein patients whose RADT results are negative.

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