A Case of Multi-focal Osteonecrosis in the Context of Liver Transplant Following Ingestion of Amanita phalloides Mushroom Toxin
Year: 2021
Type: article
Study design: Case Report
Abstract: We present the case of a 44-year-old female who presented with atraumatic avascular necrosis (AVN) of the patella and hips bilaterally, following ingestion of the deadly fungus Amanita phalloides or ‘death cap’ and subsequent liver transplant. Upon presentation, in the hours following ingestion, our patient required a liver transplant and ICU admission. She was treated by a multidisciplinary team, with input from various specialities. Our patient required steroids in the months following this event. Six months after the liver transplant and subsequent ICU admission, our patient developed hip pain, thus limiting her mobility, ability to engage in physiotherapy and rehabilitation. X-rays were performed that excluded any acute pathology. She was still receiving high-dose steroids at this time. When the pain did not resolve with analgesia, MRI of pelvis and knee was performed and the patient was found to have polyarticular AVN. Acute bilateral total hip replacement was performed and within weeks, the patient returned to physiotherapy and to full rehabilitation. Conservative management of the patella was favoured. Over two years later, the patient can now mobilise independently.
Source: Cureus
DOI: 10.7759/cureus.19513
Authors: Peggy E Miller, Paula McQuail, Charlotte F Doran, Kevin McSorley, Paul Curtin
Institutions: St. Vincent's University Hospital, St. James's Hospital
Language: English
Topic: Bone and Joint Diseases
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3211353323