Tratamiento exitoso de la intoxicación por Lepiota brunneoincarnata en Argentina / Successful treatment of Lepiota brunneoincarnata poisoning in Argentina

Resumen Los hongos con amatoxinas son los que generan la mayor cantidad de intoxicaciones mortales por mice tismo en el planeta. Estas toxinas son producidas no solo por las especies de Amanita, como la muy conocida Amanita phalloides, sino también por otros géneros, entre los que se encuentra Lepiota. En este trabajo se expone el tratamiento de un paciente de 51 años con un peso de 79 kg, derivado al hospital luego de 36 h de haber ingerido hongos, los cuales fueron identificados como Lepiota brunneoincarnata, en nuestro conocimiento una especie hallada por primera vez en la Argentina. El paciente presentaba malestar general, con náuseas y repetidos vómitos acompañados de dolor abdominal y diarrea. Gracias a una rápida anamnesis e identificación aproximada y temprana del hongo se le colocó sonda nasogástrica y se suministró carbón activado seriado. Además de N-acetilcisteína, fitomenadiona y penicilina G EV. El paciente fue dado de alta a los 11 días de su ingreso. Este caso realza la importancia de obtener una anamnesis correcta y suficiente sobre hongos, poder rea lizar un rápido análisis de ellos e iniciar un tratamiento oportuno de la intoxicación. Queda demostrado, una vez más, la importancia de tener Centros de Información y Asesoramiento Toxicológico (CIAT) con experiencia y conocimiento de micetismos.

Abstract Mushrooms containing amatoxins generate the high est number of fatal mycete poisonings on the planet. These toxins are produced not only by Amanita species, such as the well-known Amanita phalloides, but also by other genera, including Lepiota. In this work we report the treatment of a 51-year-old male patient weighing 79 kg who was referred to the hospital after 36 h of ingesting mushrooms. The mushrooms were identified as Lepiota brunneoincarnata, found for the first time in Argentina. The patient presented general malaise, nausea and repeated vomiting, abdominal pain, and diarrhea. Thanks to a quick anamnesis and early and accurate identifica tion of the fungus, he was administered a nasogastric tube and serial activated charcoal. Additionally, N-ace tylcysteine, phytomenadione and penicillin G EV were administered. The patient was discharged 11 days after admission. This case highlights the importance of obtain ing a correct and sufficient anamnesis on fungi, enabling rapid analysis of them, and initiation of timely treatment for intoxication. Once again, the importance of having Toxicological Information and Advice Centers (CIAT) with experience and knowledge of micetisms is demonstrated.

Dual effects of entomopathogenic fungi on control of the pest Lobesia botrana and the pathogenic fungus Eutypella microtheca on grapevine

BACKGROUND: Entomopathogenic fungi (EPF) are the natural enemies of insect pests. Nevertheless, research on the use of EPF for simultaneous prevention of pest and disease agents on the same crop is limited. In this study, we explored the potential dual effects of three strains of the EPF Metarhizium anisopliae on the control of detrimental agents of Vitis vinifera L., including different developmental stages (larvae, pupae, and adult) of the insect pest Lobesia botrana and the phytopathogenic fungus Eutypella microtheca. METHODS: Laboratory pathogenicity trials were performed to examine the effects of the three M. anisopliae strains on the mortality rate of L. botrana. In addition, field trials were conducted to assess the biocontrol potential of one selected M. anisopliae strain on the larval stage of L. botrana. Moreover, inhibitory effects of the three EPF strains on E. microtheca growth were examined in vitro. RESULTS: All the M. anisopliae strains were highly effective, killing all stages of L. botrana as well as inhibiting the growth of E. microtheca. The in vitro mortality of larvae treated with the strains was over 75%, whereas that of treated pupae and adults was over 85%. The three EPF strains showed similar efficacy against larvae and adult stages; never-theless, pupal mortality was observed to be strain dependent. Mortality of L. botrana larvae ranged from 64 to 91% at field conditions. Inhibition of E. microtheca growth reached 50% in comparison to the control. CONCLUSIONS: Our study showed that M. anisopliae strains were highly effective in ensuring control of two different detrimental agents of V. vinifera L., providing new evidence to support the dual effects of entomopathogenic fungi.

Hongos tóxicos en la Ciudad de Buenos Aires y alrededores / Toxic fungi in Buenos Aires City and surroundings

En la Facultad de Ciencias Exactas y Naturales de la Universidad de Buenos Aires (FCEN-UBA) funciona el Servicio de Identificación de Hongos Tóxicos. Lo integran los investigadores del Programa de Plantas Medicinales y Programa de Hongos que Intervienen en la Degradación Biológica (PROPLAME-PRHIDEB, CONICET) y colabora con servicios médicos, estatales y privados, identificando los materiales remitidos en casos de intoxicaciones con hongos, permitiendo, en muchos casos, realizar el tratamiento adecuado. El presente trabajo da a conocer los casos atendidos por el servicio desde 1985 hasta 2012 inclusive, además de una tabla para reconocer las especies tóxicas más comunes de la región. Según esta información, el 47% de las consultas que se recibieron correspondieron a pacientes menores de 18 años de edad que ingirieron materiales fúngicos de forma accidental (o al menos se sospechaba que lo hubieran hecho). El 53% restante correspondió a adultos que afirmaron ser capaces de distinguir hongos comestibles de tóxicos. Se determinó que Chlorophyllum molybdites fue la principal especie causante de intoxicaciones, la cual es comúnmente confundida con el hongo comestible Macrolepiota procera. En segundo lugar Amanita phalloides, un hongo altamente tóxico, que se caracteriza por presentar inicio de síntomas en forma tardía (latencia de 6-10 horas), evolucionando a falla hepática con el consiguiente requerimiento de trasplante o la muerte, si no se realiza el tratamiento adecuado en forma oportuna.

In Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires there is a service called Servicio de Identificación de Hongos Tóxicos, directed by researchers of the Program of Medicinal Plants and Fungi Involved in Biological Degradation (PROPLAME-PRHIDEB, CONICET) that assist hospitals and other health establishments, identifying the different samples of fungi and providing information about their toxicity, so that patients can receive the correct treatment. The objective of the present study was to analyze all the cases received from 1985 to 2012. This analysis permitted the confection of a table identifying the most common toxic species. The information gathered revealed that 47% of the patients were under 18 years of age and had eaten basidiomes; the remaining 53% were adults who insisted that they were able to distinguish edible from toxic mushrooms. Chlorophyllum molybdites turned out to be the main cause of fungal intoxication in Buenos Aires, which is commonly confused with Macrolepiota procera, an edible mushroom. In the second place Amanita phalloides was registered, an agaric known to cause severe symptoms after a long period of latency (6-10 hours), and which can lead to hepatic failure even requiring a transplant to prevent severe internal injuries or even death, is not early and correctly treated.