Syndrome muscarinique par ingestion de champignon : à propos de deux cas dont un mortel

Many poisonous fungi exist in France. However, the accidental intoxications by mushrooms remain rare. The majority of these toxic mushrooms often cause only an isolated and moderated gastroenteritis. Except the intoxications phalloidines (Amanita phalloides), responsible for 90% of the deaths, few mushrooms are responsible for death. The clinical physiopathology and pictures must be known to avoid the complications. Mushroom poisoning is rare but sometimes very serious. The prognosis is dependent to the quantity ingested and the time taken for clinical signs to appear. Generally, more the time of appearance of the signs is short after ingestion, less the mushroom is toxic. In practice, differentiation between the syndromes with short or long incubation must be moderate. Indeed certain mushrooms responsible for a muscarinic syndrome of short latency (30 min to 2 h) can be mortals in the case of ingestion massive and occurring at a “weakened” patient. It is the case of inocybes. The prehospital management is very important, because if the majority of the intoxications answers a symptomatic treatment, the serious forms require specific measurements: intravenous atropine with strong amount until disappearance of the hypersecretion. We report two cases of severe muscarinic syndrome by accidental ingestion of inocybes among which the one was mortal quickly.