Hydrogen sulfide toxicity in a thermal spring: a fatal outcome.
BACKGROUND
Hydrogen sulfide (H(2)S) 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.


METHODS
We report two cases with acute H(2)S intoxication caused by inhalation of H(2)S 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.


CONCLUSIONS
This report highlights the danger of H(2)S toxicity not only for reservoir and sewer cleaners, but also for individuals bathing in thermal springs.
Daldal
Hale
H
Department of Anaesthesiology and Reanimation, Pamukkale University School of Medicine, Kinikli, Denizli, Turkey. haledaldal@yahoo.com
Beder
Bayram
B
Serin
Simay
S
Sungurtekin
Hulya
H
D000328:Adult; D017809:Fatal Outcome; D005260:Female; D045482:Hot Springs / Q000737:chemistry*; D006801:Humans; D006862:Hydrogen Sulfide / Q000506:poisoning*; D008297:Male
D006862:Hydrogen Sulfide