Hydrogen sulfide toxicity in a thermal spring: a fatal outcome

Abstract

Introduction. Hydrogen sulfide (H₂S) is a toxic gas with the smells of “rotten egg”; its toxic effects are due to the blocking of cellular respiratory enzymes leading to cell anoxia and cell damage. Case presentation. We report two cases with acute H₂S intoxication caused by inhalation of H₂S evaporated from the water of a thermal spring. Two victims were found in a hotel room were they could take a thermal bath. A 26-year-old male was found unconscious; he was resuscitated, received supportive treatment and survived. A 25-year-old female was found dead. Autopsy showed diffuse edema and pulmonary congestion. Toxicological blood analysis of the female revealed the following concentrations: 0.68 mg/L sulfide and 0.21 mmol/L thiosulfate. The urine thiosulfate concentration was normal. Forensic investigation established that the thermal water was coming from the hotel's own illegal well. The hotel was closed. Conclusion. This report highlights the danger of H₂S toxicity not only for reservoir and sewer cleaners, but also for individuals bathing in thermal springs.

Keywords:

• Inhalation exposure
• Acute toxicity
• Hydrogen sulfide