To study the primary clinical symptoms, treatment and prognosis of mushroom poisoning in children and to explore the relevant influencing factors of its prognosis.

A total of 21 cases of children with mushroom poisoning from June 2011 to July 2016 in West China Second University Hospital were selected as research subjects. They were divided into good prognosis group (n=18, cured or improved) and poor prognosis group (n=3, giving up treatment or death) according to their prognosis. The genders, age, habitation place, the onset time of mushroom poisoning, clinical symptom, laboratory examination results, and prognosis of the 21 children were collected by retrospective method. The clinical data of two groups were statistically analyzed.

①Among the 21 cases of children with mushroom poisoning, 13 cases (61.9%) were male and 8 cases (38.1%) were female. The median age was 8.1 years old. And 2 cases were come from main urban zone of Chengdu, the other 19 cases (90.5%) were come from suburban towns of Chengdu or other cities of Sichuan Province. And 16 cases (76.2%) had clinical symptoms less than 6 h after ingesting toxicant (early-onset mushroom poisoning), 5 cases (23.8%) emerged manifestations between 6 h to 24 h after ingesting toxicant (delayed-onset mushroom poisoning). The median incubation was 3.8 h (0.5-20.0 h). The primary clinical symptoms of mushroom poisoning were diverse, the most common primary clinical symptom was vomiting (95.2%, 20/21), followed by abdominal pain (42.9%, 9/21) and diarrhea (38.1%, 8/21). Clinical diagnosis: liver dysfunction (8 cases), renal dysfunction (4 cases), cardiac damage (3 cases), coagulation disorders (3 cases), brain damage (2 cases) and hemolytic anemia (1 case). Treatment measures: 7 children received gastrolavage treatment, 13 children were treated with glucocorticoids and 10 children received 3.9 times (1-6 times) of blood purifications. Treatment outcomes: on the base of symptomatic and supportive treatment, 17 cases were cured, 1 case was turned better, 2 cases were died and 1 case gave up treatment. The 3 children in poor prognosis group all were with delayed-onset mushroom poisoning symptoms. ②Compared with the poor prognosis group, the median onset time in the good prognosis group was shorter, the numbers of damaged organs and pediatric critical illness scores were lower, and all the differences were statistically significant (t=-4.116, P=0.001; t=5.690, P<0.001; t=-3.567, P=0.002).

The symptoms are diverse in children with mushroom poisoning, which might lead to multiple organs dysfunction and serious consequences. The median onset time, damaged organs and pediatric critical illness scores can influence the prognosis of children with mushroom poisoning. Delayed-onset mushroom poisoning symptoms may lead to poor prognosis and need more attentions by clinicians.