• Xi Kei Fong Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
  • Chia Wei Phan Clinical Investigation Centre (CIC), 5th Floor, East Tower, University Malaya Medical Centre (UMMC), 59100 Lembah Pantai, Kuala Lumpur, Malaysia https://orcid.org/0000-0003-1373-1374
  • Noorasyikin Shamsuddin Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
  • Liyana Mazni Zulkifli Department of Emergency Medicine, University Malaya Medical Centre (UMMC), 59100 Lembah Pantai, Kuala Lumpur, Malaysia
  • Yee Shin Tan Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
  • Vikineswary Sabaratnam Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia




food poisoning, case study, noxious substance, Chlorophyllum molybdites, mushroom, retrospective, toxicology


There is limited information regarding the epidemiology of food poisoning in Malaysia as the issue of food poisoning is often perceived as not as huge as compared to other poisoning cases like intoxication by drugs and chemicals. Patients who experience severe food poisoning require hospitalisation, aggressive hydration, and some even require antibiotic treatment. In this study, we aimed to determine an overview of food poisoning cases reported in UMMC. A 10-year retrospective study on the poisoning of other noxious substances eaten as food (ICD10: T62.0-T62.9) in the University of Malaya Medical Centre (UMMC) was performed. A total of 23 medical records of patients, admitted from January 2009 to December 2019 were reviewed. The greatest proportion of food poisoning occurred between the ages of 0 and 9 years, with a predominance of the male gender. Malay patients accounted for most food poisoning cases. All cases of poisoning, including a mushroom poisoning case (T62.0), were accidental. The mushroom poisoning case was then carefully reviewed. To conclude, this study revealed that the most common cause involved in the poisoning was unspecified food poisoning, followed by ingestion of poisonous mushroom. Most patients were given symptomatic and supportive treatments. All patients had favourable outcomes and were discharged with full recovery.


Uges D. What is the definition of a poisoning? J Clin Forensic Med 2001; 8: 30–33.

Michael JM, Robert GH. Toxicity of muscimol and ibotenic acid containing mushrooms reported to a regional poison control center from 2002–2016. Clin Toxicol 2019;57: 99-103.

Ezat WP, Netty D, Sangaran G. Paper review of factors, surveillance and burden of food borne disease outbreak in Malaysia. Malaysian J Med Health Sci 2013; 13.

Abd W, Lani M, Zin W, Abdullah WZW, Chilek TZT, Hassan Z. A review on incidences of foodborne diseases and interventions for a better national food safety system in Malaysia. Malays Appl Biol 2017; 46: 1–7.

Abd-Mutalib N A, Syafinaz AN, Sakai K, Shirai Y. An overview of foodborne illness and food safety in Malaysia. Int Food Res J 2015;22: 896–901.

Ministry of Health Malaysia. 2016. Annual report. Retrieved from http://vlib.moh.gov.my/cms/documentstorage/com.tms.cms.document.Document_cfdfa3ab-a0188549-ebcfa200-b93847c6/anr-bi-2016.pdf

New CY, Ubong A, Premarathne JM, Thung TY, Lee E, Chang WS, Loo YY, Kwan SY, Tan CW, Kuan CH, Son R. Microbiological food safety in Malaysia from the academician’s perspective. J Food Sci 2017; 1:183–202.

Teisl M, Roe B. Consumer willingness-to-pay to reduce the probability of retail foodborne pathogen contamination. Food Policy 2010; 35(6): 521–530.

Pires SM, Vieira AR, Perez E, Danilo LFW, Hald T. Attributing human foodborne illness to food sources and water in Latin America and the Caribbean using data from outbreak investigations. Int J Food Microbiol 2012; 152(3): 129–138.

Diaz JH. Amatoxin-containing mushroom poisonings: species, toxidromes, treatments, and outcomes. Wilderness Environ Med 2018; 29(1): 111–118.

Berger KJ, Guss DA. Mycotoxins revisited: Part I. J Emerg Med 2005; 28(1): 53–62.

Schenk-Jaeger KM, Rauber-Luthy C, Bodmer M, Kupferschmidt H, Kullak-Ublick GA, Ceschi A. Mushroom poisoning: a study on circumstances of exposure and patterns of toxicity. Eur J Intern Med 2012; 23(4): e85-91.

Sergey G, Josef D, Aristidis T, Ramin R. Poisoning associated with the use of mushrooms: a review of the global pattern and main characteristics. Food Chem Toxicol 2019;128: 267–279.

Soltaninejad K. Outbreak of mushroom poisoning in Iran: April-May, 2018. Int J Occup Environ Med 2018;9(3): 152–156.

Jo WS, Hossain MA, Park SC. Toxicological profiles of poisonous, edible, and medicinal mushrooms. Mycobiology 2014;42(3): 215–220.

Eren SH, Demirel Y, Ugurlu S, Korkmaz I, Aktas C, Güven FMK. Mushroom poisoning: retrospective analysis of 294 cases. Clinics 2010; 65:491–496.

Keller SA, Jolanta KR. Mushroom poisoning- a 17-year retrospective study at a level I university emergency department in Switzerland. Int J Environ Res Public Health 2018; 15(12):2855.

Ukwuru M, Muritala A, Eze LU. Edible and non-edible wild mushrooms: nutrition, toxicity and strategies for recognition. J Clin Nutr Metab 2018; 2(2): 9.

Jan MA, Siddiqui TS, Ahmed N, Ul Haq I, Khan Z. Mushroom poisoning in children: clinical presentation and outcome. J Ayub Med Coll Abbottabad 2008; 20(2): 99–101.

Khatir IG, Hosseininejad SM, Ghasempouri SK, Asadollahpoor A, Moradi S, Jahanian F. Demographic and epidemiologic evaluation of mushroom poisoning: a retrospective study in 4-year admissions of Razi Hospital (Qaemshahr, Mazandaran, Iran). Med Glas (Zenica) 2020; 17(1):117-122.

Broussard CN, Aggarwal A, Lacey SR, Post AB, Gramlich T, Henderson JM, Younossi ZM. Mushroom poisoning--from diarrhea to liver transplantation. Am J Gastroenterol 2001;96(11): 3195–3198.

Abd-Elhale ZA, Abd-Elkari MA. Pattern of food poisoning in Egypt, a retrospective study. Am J Pharmacol Toxicol 2011;6: 505–515.

Kasilo OM, Nhachi CF. Food poisoning admissions in referral hospitals in Zimbabwe: A retrospective study. Hum Exp Toxicol 1994;13(2): 77–82.

Okoronkwo CU. Food poisoning of the infantile group, microbiological standpoint. J Food Nutrition and Population Health 2020; 4(4):18.

Tangiisuran B, Jiva M, Ariff AM, Abdul Rani NA, Misnan A, Rashid SM, Majid MIA, Dawson AH. Evaluation of types of poisoning exposure calls managed by the Malaysia National Poison Centre (2006-2015): A retrospective review. BMJ Open 2018; 31;8(12):e024162.

Ministry of Health Malaysia. 2006. Malaysia's health. Retrieved from https://www.moh.gov.my/moh/images/gallery/publications/mh/Malaysia%20Health%202006-2.pdf

Tunik MG. Food Poisoning. In: Goldfrank`s Manual of Toxicol Emerg. (9th ed.; L. S. Nelson R.S. Hoffman, N.A. Lewin, L.R. Goldfrank, M.A. Howland and N.E. Flomenbaum, Ed.). 2007. New York: McGraw Hill Companies.

Keith AL, Susan MC, Sufian AK. Bad bug book: handbook of foodborne pathogenic, microorganisms and natural toxins. (2nd ed.). 2012. USA: Food and Drug Administration.

Chadha I. Poisoning. Indian J Anaesth 2003;47(5): 402.

Mokhlesi B, Leiken JB, Murray P, Corbridge TC. Adult toxicology in critical care: part I: general approach to the intoxicated patient. CHEST 2003;123(2): 577–592.

Al-Haidari KM. General Management of Poisoned Patients. In: Elzouki AY, Harfi HA, Nazer HM, Stapleton FB, Oh W, Whitley RJ (eds) Textbook of Clinical Pediatrics. 2012. Springer, Berlin, Heidelberg.

Ministry of Health, Singapore. MOH Clinical Practice Guidelines, December 2011. Available from: http://www.moh.gov.sg/cpg (accessed 24 June 2021)

On SLW, Rahayu, WP. Estimates for the burden and costs of foodborne diarrhoeal illness in Indonesia. Asia-Pacific J Food Safety and Security 2017; 3(1):3-16.

World WHO [World Health Organisation]. WHO estimates of the global burden of food-borne diseases. World Health Organisation (Publishers) 2016, ISBN 978 92 4 156516 5.

Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet 2002; 360(9343):1347–1360.

Palanimuthu B, ldrose A, Sabaratnam V. OP 2 "Tempting mushroom with deadly bites - dinner that almost kill my family"-case series of Chlorophyllum molybdites mushroom poisoning. Malaysian J Emergency Med 2016;1(2): Supplementary Issue 1-2.

Phyllis H. Stenklyft, W. Lynn Augenstein. Chlorophyllum molybdites-severe mushroom poisoning in a child. Clin Toxicol 1990; 28(2): 159-168.

Pajoumand A, Shadnia S, Efricheh H, Mandgary A, Hassanian-Moghaddam H, Abdollahi M. A retrospective study of mushroom poisoning in Iran. Hum Exp Toxicol 2006; 24: 609–613.

Köppel C. Clinical symptomatology and management of mushroom poisoning. Toxicon 1993; 31(12):1513-40.

Jonathan De Olano, Josh J. Wang, Eric Villeneuve, Sophie Gosselin, Rana Biary, Mark K. Su, Robert S. Hoffman. Current fatality rate of suspected cyclopeptide mushroom poisoning in the United States. 2020. Clin Toxicol. DOI: 10.1080/15563650.2020.1747624




How to Cite

Fong, X. K. ., Phan, C. W., Noorasyikin Shamsuddin, Liyana Mazni Zulkifli, Tan, Y. S., & Sabaratnam, V. . (2021). POISONING CASES OF NOXIOUS SUBSTANCES EATEN AS FOOD: A RETROSPECTIVE STUDY AT A TEACHING HOSPITAL IN MALAYSIA. Malaysian Journal of Public Health Medicine, 21(2), 178–189. https://doi.org/10.37268/mjphm/vol.21/no.2/art.911