Severe bongkrekic acid poisoning caused by eating spoiled Auricularia auricula: a case report

Bongkrekic acid is a rare mitochondrial toxin produced by the Burkholderia cocovenenans subsp. Bongkrekic acid poisoning has a case fatality rate of more than 50%, and progresses rapidly to multiple organ failure. However, limited clinical information is available regarding this phenomenon.

We report the case of a 77-year-old female patient with severe bongkrekic acid poisoning after consuming Auricularia auricula. The patient was treated for sweating, unconsciousness, nausea, vomiting, and acute hepatic failure. The patient died despite receiving supportive care and undergoing plasmapheresis.

Bongkrekic acid poisoning causes high mortality, but is often mistakenly categorized as a minor foodborne disease. In reporting this case, we aimed to increase the awareness of healthcare providers as well as the public about the risks posed by bongkrekic acid. Medical staff being familiar with the clinical manifestations of bongkrekic acid poisoning is necessary to take corresponding measures to effectively treat patients. Safer fermentation processes and food handling should be emphasized to prevent the occurrence of bongkrekic acid poisoning.