Mushroom poisoning and heavy metal intoxications

1. Big picture

This topic has two classic exam patterns:

Mushroom poisoning is mainly a time-course diagnosis. The most dangerous pattern is: delayed severe gastrointestinal symptoms after wild mushroom ingestion → transient improvement → acute liver failure, which means amatoxin poisoning, classically Amanita phalloides.

Heavy metal intoxication is mainly a multi-system chronic toxicity pattern. Think of it when the patient has unexplained combinations of abdominal pain, neuropathy, anemia, renal injury, neuropsychiatric symptoms, skin changes, and occupational/environmental exposure.

Core emergency approach:

Suspected mushroom/heavy metal poisoning
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ABCDE stabilization
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Identify exposure + time course
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Check glucose, ECG, renal/liver tests, acid-base status
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Decontaminate if early and safe
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Give toxin-specific antidote/chelator when indicated
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Monitor liver, kidney, neurologic, hematologic complications
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Early referral: toxicology center / ICU / liver transplant center if severe

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