Mycopathologia
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Hepatotoxic mushroom poisoning (due to Amanita, Lepiota and Galerina species) may be considered as a real medical emergency, since an early diagnosis and immediate treatment are required for a successful outcome. In this review the physio-pathological features and the clinical picture of amatoxin poisonings are described as the basis for diagnosis and therapeutic decisions. ⋯ Some parameters with prognostic significance are commented on. Finally, the mortality rate and its evolution throughout the present century is also considered.
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The mushroom Lepiota josserandii Bon and Boif. has been identified as the cause of an unintentional, fatal intoxication in New York. The course of the symptoms, beginning with a 9 h latent period, was similar to what would be expected in a case of Amanita phalloides-type intoxication. Despite supportive medical care the victim expired 110 h after ingestion. Thin layer chromatography detected the presence of alpha- and gamma-amanitin and radioimmunoassay confirmed a level of 3.5 mg/gm dry weight of amatoxins in mushrooms from the same location.
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Paracoccidioidomycosis is an important Latin American endemy. The lung is the portal of entrance of the infection and the lesions are confined to this organ in, at least, 30 per cent of the progressive cases. Twelve case histories of patients with the progressive pulmonary form are presented in order to illustrate the repetitious clinical manifestations but the large variety of radiological presentations. The mycologic diagnosis is also emphasized.