Epidemiological and clinical characteristics of severe poisonous mushroom poisoning in children in Yunnan Province: A retrospective analysis of 23 cases from 2020 to 2022

Poisonous mushroom poisoning is a common and highly fatal foodborne disease in southwest China. Children are at higher risk of severe illness and death due to limited hepatic reserve. However, studies on the poisonous mushroom poisoning in children are still limited. To analyze the epidemiological characteristics, clinical features, laboratory findings, treatment modalities, and prognostic factors of severe poisonous mushroom poisoning in children in Yunnan Province from 2020 to 2022. This was a retrospective study that included 23 hospitalized pediatric cases diagnosed with poisonous mushroom poisoning in Yunnan Province from 2020 to 2022. The Mann-Whitney U test was used to analyze the difference between alanine aminotransferase (ALT) and prothrombin time (PT) levels between the death and survival groups, and Spearman correlation analysis was used to assess their correlation with prognosis; the Fisher exact test and Fisher-Freeman-Halton test were used to compare the prognostic effects of blood purification treatment with different purification modalities. Poisoning cases clustered in summer-autumn, with Amanita species predominance. Acute liver injury type was the most common. ALT and PT levels were significantly higher in the death group (P = .013 and P = .025) and positively correlated with mortality (ALT: R = 0.538, P = .008; PT: R = 0.485, P = .019). Blood purification therapy significantly improved survival (64.7% vs 16.7%, P = .026), with no significant difference among modalities (P = .162). Elevated ALT and prolonged PT are key prognostic indicators of mortality in pediatric mushroom poisoning. Blood purification therapy improves survival. Dynamic monitoring of ALT and PT may aid early risk stratification and optimization of treatment strategies.