急性中毒 ニセクロハツ中毒：横紋筋融解症

Back pain after wild mushroom consumption

Nishiyama K, Ohta Y, Matsuda N, Fujimoto R, Koike K.
Emerg Med J. 2010 Jan;27(1):61.


　A 62-year-old man was brought to the hospital with back pain and muscle weakness accompanied by myalgia. These symptoms developed 20 h after he had consumed his last meal which included the wild mushroom Russula subnigricans. The muscle weakness persisted for over a week. The maximal serum creatine kinase activity was 42,689 U/L. The patient did not have a history of trauma, pharmacotherapy or any other known causative factor that could explain the occurrence of rhabdomyolysis. Additional tests performed to detect the presence of parasites and other micro-organisms as well as systemic diseases were negative.

　Magnetic resonance imaging (MRI) has been shown to be more sensitive than CT scanning or ultrasonography for detecting muscle abnormalities.1 MRI of the muscle using the short TI inversion recovery (STIR) technique revealed diffuse high signal intensity in the bilateral infraspinatus (white arrow) and left supraspinatus muscles (white arrowheads), confirming rhabdomyolysis.

Muscle MRI image（STIR）
Short TI inversion recovery (STIR) images of bilateral shoulder showing high density areas in the bilateral infraspinatus muscle (white arrow) and left supraspinatus muscle (white arrow).

ニセクロハツ
ベニタケ科
Russula subnigricans

食毒：毒
発生時期：夏～秋
発生場所：マツ・コナラ、シイ・カシ林
傘：中央窪む、灰褐色
傘の下面：ヒダ、直生～やや垂生、疎、傷口赤変するが黒変しない
柄：中実