Acute liver injury and facial edema following ingestion of mushroom Descolea quercina.

In September 2025, a fresh wild mushroom poisoning incident involving five individuals occurred in Sichuan Province, China, three of whom developed poisoning symptoms. Mushroom specimens were collected and identified as Descolea quercina through morphological and phylogenetic analyses. Epidemiological investigation showed that one patient with a high estimated intake (>500 g) developed acute liver injury, with markedly elevated transaminases (ALT 525 U/L, AST 482 U/L), along with facial edema-a rarely reported sign. This patient had stable hyperthyroidism and responded favorably to hepatoprotective therapy. Notably, this patient did not develop vomiting until over 18 hours after ingestion, allowing extensive toxin absorption. In contrast, another patient who also ingested a high dose (>500 g) vomited within 3 h and received emetic therapy to promote evacuation of residual mushrooms, thereby limiting absorption; this patient experienced only severe gastrointestinal symptoms without hepatic injury, and although laboratory tests were performed with normal results, the detailed reports were not retained. A low-dose patient (25-50 g) had only mild gastrointestinal discomfort, and the two remaining individuals who consumed just a few bites remained asymptomatic; these three patients did not seek medical care. These observations suggest that clinical severity is primarily determined by the absorbed toxin dose, and early emesis plays a critical protective role by reducing systemic exposure. This study is the first detailed report of poisoning caused by D. quercina, documenting its clinical manifestations and providing a scientific basis for diagnosis, treatment, and prevention of similar events.