Iranian Journal of Toxicology
مجله سم شناسی و مسمومیتهای ایران
IJT
Medical Sciences
http://ijt.arakmu.ac.ir
1
admin
2008-2967
2251-9459
8
10.61186/ijt
14
8888
13
en
jalali
1390
7
1
gregorian
2011
10
1
5
14
online
1
fulltext
en
Amanita Phalloides Intoxication Misdiagnosed as Acute Appendicitis: A Case Report
Amanita Phalloides Intoxication Misdiagnosed as Acute Appendicitis: A Case Report
عمومى
General
پژوهشي
Research
<b>Background: </b>Acute appendicitis is the most common surgical emergency of the childhood. Its diagnosis is really challenging. A constellation of through history taking, physical examination, radiographic investigations, and laboratory analysis should be used to balance the risk of delayed operative intervention against the removal of a normal appendix. Here a case with misdiagnosis of acute appendicitis instead of Amanita Phalloides intoxication was presented. <br><b>Case:</b> A 6-years-girl was referred with history of constant, not-colicky lower quadrant and periumblical abdominal pain from 24 hours ago associated with nausea and vomiting. In physical examination generalized tenderness particularly in lower quadrants was found. leukocytosis (WBC=22000) with a shift to left (PMN=91%) and hypoglycemia was found too. Alvarado score for diagnosis of acute appendicitis was 7 out of 10. In laparotomy, the appendix appeared normal. Blood study revealed INR>7 during operation which was partially corrected with FFP infusion. The patient developed decreased levels of consciousness and was transferred to ICU. Further history taken from her family by the clinical toxicologist revealed that she had eaten wild mushrooms. After examination of the remaining mushrooms by an experienced biologist, the diagnosis of Amanita Phalloides intoxication was established. The patient died tomorrow regardless of appropriate interventions. <br><b>Conclusion: </b>Mushroom poisoning should be taken into account in evaluation of the patients suspected to have acute appendicitis. If diagnosis of mushroom poisoning was made earlier by proper history taking and a high index of suspicion, the patient would receive the available treatment modalities earlier and her chance of survival would increase.
Acute Appendicitis, Amanita Phalloides, Intoxication.
Acute Appendicitis, Amanita Phalloides, Intoxication.
527
530
http://ijt.arakmu.ac.ir/browse.php?a_code=A-10-2-80&slc_lang=en&sid=1
Mahmoud
Amini
محمود
امینی
10031947532846003199
10031947532846003199
No
Arak University of Medical Sciences, Arak, Iran.
Arak University of Medical Sciences, Arak, Iran.
Ali
Ahmadabadi
علی
احمدآبادی
a_ahmaddy@yahoo.com
10031947532846003200
10031947532846003200
Yes
Arak University of Medical Sciences, Arak, Iran.
Arak University of Medical Sciences, Arak, Iran.
Amir Mohammad
Kazemifar
امیرمحمد
کاظمی فر
10031947532846003201
10031947532846003201
No
Ghazvin University of Medical Sciences, Ghazvin, Iran.
Ghazvin University of Medical Sciences, Ghazvin, Iran.
Hassan
Solhi
حسن
صلحی
10031947532846003202
10031947532846003202
No
Arak University of Medical Sciences, Arak, Iran.
Arak University of Medical Sciences, Arak, Iran.
Yahya
Jand
یحیی
ژند
10031947532846003203
10031947532846003203
No
Arak University of Medical Sciences, Arak, Iran.
Arak University of Medical Sciences, Arak, Iran.