Clinical effects, outcomes, and disposition of unintentional pediatric mushroom exposures reported to United States poison centers from 2009 through 2023.

Introduction: Pediatric exposures to mushrooms can cause distress to parents and healthcare workers due to fear that ingestion could be toxic or fatal. This study aims to characterize the clinical effects, outcomes and disposition of unintentional pediatric mushroom exposures reported to poison centers in the United States over the past 15 years.

Methods: This is a retrospective study of the National Poison Data System^® from 2009 to 2023, which analyzes unintentional single-substance mushroom exposures in patients aged 5 years or younger. The primary outcomes were the rate of clinical effects, medical outcomes, and disposition. The secondary outcome was medical outcomes amongst patients who received activated charcoal.

Results: There were 50,323 exposures, but no symptoms (89.4%) were reported in the majority of children, and most were managed at home (80.1%). Minor effects were reported in 5.0% of exposures, moderate effects in 0.6% of exposures, and major effects in 0.03% of exposures. Two patients received transplants. In the group of patients who received activated charcoal (7.2%), 7.0% had minor effects, 0.6% reported moderate effects, and 0.05% reported major effects. The type of mushroom was reported as unknown in 92.1% of cases.

Discussion: This study shows that clinically significant symptoms and outcomes are rare from unintentional exposures to mushrooms in children aged 5 years or younger, even without mushroom identification. Of 50,323 exposures, major outcomes were reported only in 17. Symptoms were not reported in the majority of children regardless of activated charcoal administration.

Conclusion: In the absence of symptoms, it may be safe to manage children with unintentional mushroom exposures at home, even without mushroom identification, due to the low risk for adverse outcomes.