ABSTRACT
INTRODUCTION: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
