Hydrogen Sulfide Exposure in an Adult Male

Hydrogen sulfide (H₂ S) is responsible for many incidents of occupational toxic exposure, especially in the petroleum industry. The clinical effects of H₂ S depend on its concentration and the duration of exposure. H₂ S is immediately fatal when concentrations are over 500-1000 parts per million (ppm) but exposure to lower concentrations, such as 10-500 ppm, can cause various respiratory symptoms that range from rhinitis to acute respiratory failure. H₂ S may also affect multiple organs, causing temporary or permanent derangements in the nervous, cardiovascular, renal, hepatic, and hematological systems. We present a case of occupational exposure to H₂ S leading to multi-organ involvement, acute respiratory failure, organizing pneumonia, and shock resembling acute sepsis. The patient also developed mild obstructive and restrictive pulmonary disease and peripheral neuropathy.