Clinical characteristics in Russula subnigricans poisoning: a retrospective study of 103 cases

Background Mushroom poisoning, a form of foodborne intoxication, poses serious life-threatening risks in severe cases. Russula subnigricans , a rare but highly toxic species, warrants particular attention due to its unique symptom profile and clinical manifestations. Methods We conducted a retrospective analysis of 103 patients with confirmed highly suspected Russula subnigricans poisoning admitted to the Affiliated Hospital of Yunnan University between 2020 and 2024. Data encompassed epidemiological characteristics, clinical manifestation, laboratory findings, and treatment outcomes. Results Patients were predominantly middle-aged (61.2%) and from Yunnan Province (93.2%), with most poisonings (93.2%) resulting from Self-picking. Symptom onset was rapid (median latency, 2.4 h), primarily featuring gastrointestinal, cardiovascular, and rhabdomyolysis-related manifestations. Laboratory findings revealed high rates of hepatotoxicity (97.1%) and myocardial injury (85.4%). A combination of conventional therapy and blood purification was employed in 60.2% of cases, yielding favorable outcomes. After treatment at Yunnan University Affiliated Hospital, the final clinical outcomes were as follows: 91 patients (88.3%) recovered and were discharged. Conclusion Russula subnigricans poisoning is characterized by severe multi-organ toxicity. The adjunctive application of blood purification in combination with conventional therapy appears associated with improved clinical outcomes, although no specific antidote exists. Future research should focus on elucidating toxin mechanisms and toxicokinetics to guide targeted treatment and prevention strategies.