Two cases of incidental Podostroma cornu-damae poisoning

Abstract

Podostroma cornu-damae is a rare, deadly fungus. However, it can be easily mistaken for antler Ganoderma lucidum. In this case report, two patients made tea with the fungus and drank it over a 2-week period. Both patients presented with bicytopenia, and one patient had desquamation of the palms and soles. Both were treated with prophylactic antibiotics and granulocyte colony-stimulating factor. One patient was admitted to the intensive care unit and received a platelet transfusion. Both patients were discharged without complications. Podostroma cornu-damae infections caused by intoxication were successfully treated using our treatment strategy, which consisted of prophylactic antibiotics, platelet transfusion, and granulocyte colony-stimulating factor. We believe this report can guide future treatment.

Alopecia and Associated Toxic Agents: A Systematic Review

“…Although the mechanism by which the toxin acts is unknown, several fatalities associated with this fungus have been reported in Japan. Kim et al [52] described 2 cases in Korea of accidental P. cornu-damae poisoning because the patients mistakenly made tea from the toxic fungus, thinking it was Ganoderma lucidum, a popular health food. Only 1 of the patients experienced alopecia 5 days after initial ingestion, as well as fever, weakness, abdominal discomfort, desquamation of hands and feet, and neutropenia [52].…”

“…Kim et al [52] described 2 cases in Korea of accidental P. cornu-damae poisoning because the patients mistakenly made tea from the toxic fungus, thinking it was Ganoderma lucidum, a popular health food. Only 1 of the patients experienced alopecia 5 days after initial ingestion, as well as fever, weakness, abdominal discomfort, desquamation of hands and feet, and neutropenia [52]. Ahn et al [53] reported similar cases, also in Korea, of 2 patients poisoned after mistaking P. cornu-damae for G. lucidum .…”

Toxicological analysis of satratoxins, the main toxins in the mushroom Trichoderma cornu-damae, in human serum and mushroom samples by liquid chromatography–tandem mass spectrometry

“…1), also called "poison fire coral" or "kaen-take" (in Japanese), is a deadly toxic mushroom native to East Asia, Southeast Asia and Oceania [1][2][3]. Poisoning cases involving T. cornu-damae have been reported [4][5][6][7][8][9][10][11] including fatal cases [4][5][6][7][8]11], and the main toxins in T. cornu-damae have been identified as trichothecene macrolides, specifically satratoxin H and its 12′-acetate, 13′-acetate and 12′,13′-diacetate ( Fig. 2) [12].…”

“…The severity of these endotoxic shock-like symptoms depends on the amount of T. cornu-damae ingested. If only a small amount is ingested, these symptoms are mild [7,9,10], but if a lethal amount is ingested, these symptoms are severe and can result in death [4][5][6][7][8]11]. Ingestion of 1 g of T. cornu-damae can be fatal for an adult male [4].…”

“…Ingestion of 1 g of T. cornu-damae can be fatal for an adult male [4]. Within a week of T. cornu-damae ingestion, protein synthesis inhibition and skin capillary disorders cause desquamation of the palms, sole, face or chest, and hair loss [4,7,9,10] and T. cornu-damae is known as the only mushroom that causes contact dermatitis. These are considered to be characteristic symptoms of T. cornu-damae poisoning in both non-fatal and fatal cases.…”