A rare case of Amanita vidua poisoning

The similarities between poisonous and edible mushrooms, combined with the inexperience of foragers, increase the risk of mushroom poisoning. Amatoxin-containing mushrooms are responsible for most fatal mushroom poisonings. However, there is limited clinical data regarding the toxin content of certain Amanita species, such as Amanita vidua, and the severity of poisoning they may cause if consumed. This case report presents the first documented instance of poisoning from A. vidua in the literature. A 72-year-old woman mistakenly consumed a toxic A. vidua mushroom, believing it to be the non-toxic Amanita vaginata. Approximately 10 hours later, she arrived at the emergency room with symptoms including nausea, vomiting, and diarrhea. All laboratory parameters were normal on the first day. However, the patient subsequently developed refractory circulatory shock and multiple organ failure, which began on the second day and rapidly worsened over the following days. Liver function tests peaked at 73 hours post-ingestion, showing aspartate transaminase levels of 2534 IU/L, alanine transaminase levels exceeding 942 IU/L, and lactate dehydrogenase levels above 3325 U/L. We identified A. vidua by both macroscopic and microscopic examinations. Additionally, high-performance liquid chromatography (HPLC) analysis of the consumed A. vidua mushroom detected the presence of toxic alpha- and beta-amanitins, confirming amatoxin poisoning. This study details a case of A. vidua mushroom poisoning that occurred in Türkiye, ultimately resulting in death despite treatment. This is significant as it represents the first known case of poisoning worldwide from A. vidua, highlighting its potential lethality when ingested by humans.