In the context of mushroom poisoning, Acromelalga syndrome may develop, characterized by pain and neurological symptoms. Consumption of the fragrant funnel mushroom and Japanese bamboo funnel mushroom are the cause of intoxication. In most cases, the poisoning does not leave any permanent damage.
What is Acromelalga syndrome?
Poisonous mushrooms are the cause of Acromelalga syndrome. Until now, poisoning has been associated primarily with the fragrant funnel mushroom. Acromelalga syndrome corresponds to mushroom poisoning. In the Pacific region, this phenomenon has been known since the beginning of the 20th century. Within Europe, no significant case has been reported until the 21st century. The fingers, ears, toes and nose as well as legs and arms of the patients cause considerable pain in the course of intoxication. Several poisonous mushrooms are now known as causes. Overall, however, the syndrome occurs rarely worldwide. The first symptoms of intoxication appear only after a certain latency period. The affected persons therefore do not always think directly of the mushrooms consumed days before when they investigate the cause. Within Europe, Acromelalga syndrome first appeared in France in 2001. Usually, the poisoning does not result in death and does not cause permanent damage.
Causes
Poisonous mushrooms are the cause of Acromelalga syndrome. So far, the poisoning has been associated mainly with the fragrant funnel mushroom and the Japanese bamboo funnel mushroom. However, the fact that the consumption of other mushroom species can also cause the syndrome is not completely ruled out. The substance acromelic acid is present in both the fragrant funnel mushroom and the Japanese tree funnel mushroom. This acid is included in the name of the syndrome and plays an important role in intoxication. Therefore, all poisonings with foods containing acromelic acid show approximately the same symptoms as Acromelalga syndrome. Acromelic acid is a highly effective antagonist of glutamate, i.e., an opponent of α-amino acids as they occur in the human organism. Specifically, α-amino acids are found in proteins. As neurotransmitters, they exhibit a stimulating effect on the central nervous system. As antagonists of α-amino acids, they block their effectiveness in the nervous system by binding to their receptors.
Symptoms, complaints, and signs
In Acromelalga syndrome, patients complain of severe pain throughout the body. In particular, the ears and nose, as well as the arms and legs, usually hurt persistently and severely. In addition to this pain symptomatology, various neurological symptoms occur. As the poisoning blocks the effectiveness of α-amino acids, various functions in the central nervous system are inhibited. Among the most important symptoms, paralysis and insensations or numbness of the arms and legs are the main ones. In addition, depression and severe fatigue may occur. Sometimes swelling and dermatological abnormalities also occur. Patients suffer from cramps and persistent insomnia, usually caused mainly by the muscle pain. Heat can worsen symptoms and cause numbness in the legs, for example, to first mature into paralysis.
Diagnosis and course
Symptoms of Acromelalga syndrome appear one to two days or even a full week after eating the mushrooms. This makes it difficult for the doctor to diagnose. Mushroom debris in the patient’s vomit gives him at best an initial suspicion of mushroom poisoning. The medical history can substantiate this suspicion. As a rule, the detection of acromelic acid in the patient’s organism is considered to confirm the diagnosis. This evidence is provided by laboratory tests of the blood. Acromelalga syndrome is associated with a favorable prognosis. A fatal outcome or permanent damage is relatively unlikely. However, how long patients are tormented by symptoms depends on the individual case. Poisoning tends to be prolonged and may produce symptoms for weeks or even months.
Complications
If wrong mushroom consumption is suspected, the affected person should immediately seek medical attention. Acromelalga syndrome causes significant complications depending on the patient’s condition, but does not result in death. Triggers for intoxication are various poisonous mushrooms.Sufferers complain of severe pain in the extremities as well as in the nose and ears. The skin may swell, heat is not tolerated, and severe muscle cramps and fatigue plague the body. Furthermore, numbness and paralysis may occur in the arms and legs. Especially in emotionally unstable patients, an existing depression can worsen. In the worst case, the central nervous system fails, as the functioning of the α-amino acids is downright blocked. This type of fungal poisoning does not leave any damage to the organs, nevertheless, due to the severity of the clinical picture, the affected person needs a certain period of recovery. There is no antidote for Acromelalga syndrome. As an immediate medical measure, fluid intake is used to try to reduce the amount of poison ingested so that it can be broken down more quickly by the body. In addition, sedatives and analgesics are used.
When should you see a doctor?
Whether or not to see a doctor for Acromelalga syndrome usually depends on the severity of the symptoms. The poisoning itself is not particularly dangerous to the human body and does not require special treatment. As a rule, the poisoning does not cause any permanent damage that would become noticeable later in life. However, if the pain or discomfort becomes unbearable for the patient, a doctor must be consulted. This is especially the case if Acromelalga syndrome causes paralysis in various regions of the body. These limit the patient’s movement and should be treated. Persistent fatigue and insomnia may also be a sign of Acromelalga syndrome. A doctor must also be consulted directly if muscle cramps occur, as this usually results in very severe pain. If there is a loss of consciousness, an emergency physician should be called immediately. Usually, the affected person can consume a large amount of fluid to minimize the discomfort of Acromelalga syndrome.
Treatment and therapy
Normally, in cases of poisoning, the physician attempts to induce vomiting in order to get the remnants of the toxic food out of the patient’s system. This attempt can be done by administering emetics. Pumping out the stomach is also a possibility. Acromelalga syndrome shows first symptoms on average only after several days. Therefore, vomiting in this phenomenon is usually not of breakthrough therapeutic success, because a certain amount of the toxins has already been adsorbed in the stomach and intestines. Nonetheless, the attempt should be made, since the amount of toxin can thus at least be reduced with a little luck. A curative treatment for Acromelalga syndrome does not yet exist, as no antidote is known. However, the symptoms of the syndrome can be treated to a certain extent. For example, for the pain, strong analgesics such as Novalgin are administered in high doses as needed. For the psychological upsets, the doctor may give sedatives if necessary. Remission of symptoms can be expected within weeks. If, contrary to expectations, the neurologic symptoms of the syndrome do not remit, physical therapy is usually prescribed.
Outlook and prognosis
Acromelalga syndrome does not usually cause any special damage or complications. The patient suffers from complaints of the nervous system, which occur due to the poisoning. Thereby, the patient may suffer from insensations and numbness in different regions of the body. Furthermore, paralysis also occurs, which can lead to a restriction of movement. In some cases, the restrictions and paralysis also cause depression and other psychological complaints. The affected person feels sick and tired. The muscles ache and, in severe cases, cramps may occur. Often the symptoms of poisoning can also lead to a panic attack. Usually, medical treatment for Acromelalga syndrome is not needed and the symptoms disappear when the body has broken down the poison. In acute cases or when symptoms are life-threatening, medications may be used to treat them. Often, ordinary vomiting also helps to get the toxin out of the body. If the patient complains of mental discomfort, appropriate medication can also be prescribed by the doctor.Life expectancy is not usually reduced by Acromelalga syndrome and there is a positive disease outcome in most cases.
Prevention
Acromelalga syndrome can be prevented by being conscientious about mushroom consumption. Poisonous mushrooms such as the fragrant funnel mushroom and the Japanese bamboo funnel mushroom should not be consumed. All other poisonous mushrooms are also not suitable for consumption. Mushroom foragers should therefore either know about mushrooms themselves or consult an experienced body rather than simply eating their pickings.
Aftercare
Acromelalga syndrome can be treated well today. With appropriate follow-up care, symptoms can be resolved within a few days. The patient should take it easy for a few weeks afterward and not perform any physically strenuous activities. The physician will usually recommend bed rest and, if necessary, an appropriate diet so that the remaining fungal toxin is flushed out of the organism. Typically, laxative foods such as cabbage or beans are recommended. Caffeine and alcohol should be avoided initially, as the kidney is still busy flushing out the acromelic acid. In addition, in Acromelalga syndrome, the cause of the symptoms must be determined to prevent recurrence of poisoning. As part of the follow-up, the physician will perform another physical examination and also conduct a comprehensive interview with the patient. Based on the results, the trigger can be determined. Appropriate countermeasures must then be initiated, i.e., disposal of the causative food or avoidance of certain substances containing substances of the Perfumed Funnelwort or Japanese Bamboo Funnelwort. Psychological measures are usually not necessary. However, in individual cases it may be useful to work through the disease in the context of trauma therapy. Especially in cases of severe illness, where the patient’s life was in danger in the meantime, at least a conversation with a therapist should take place.
What you can do yourself
In any case, mushroom poisoning should be treated by a doctor, especially since Acromelalga syndrome can lead to neurological disorders. Affected persons mostly do not tolerate heat. Therefore, a cool room should be visited or additional cooling by an air conditioner and sufficient shading should be provided. If no dermatoses have formed, cooling compresses can also increase the feeling of well-being. To reduce the pain in the arms and legs, the doctor often prescribes mild painkillers or analgesics. These can be taken for a limited period of time. Since there is no antidote, treatment can be based only on rapid elimination of the toxins. First, it is advised to greatly increase fluid intake to reduce the amount of toxin in the body. Artificially induced vomiting – via an emetic – is also medically advised. Furthermore, taking healing clay or bentonite can help bind the toxins already absorbed by the stomach and intestines. These are then excreted in the stool. For very sensitive patients or those prone to depression, sedatives can also be taken. Homeopathically, the remedies Nux Vomica and Arsenum support existing poisoning. If pain and paralysis symptoms intensify in a very short time or if shock even occurs, the emergency physician should be consulted immediately. In most cases, however, the condition can be treated at home.
