Hydrogen sulfide exposure in an adult male

Hydrogen sulfide (H 2 S) is responsible for many incidents of occupational toxic exposure, especially in the petroleum industry. The clinical effects of H 2 S depend on its concentration and the duration of exposure. H 2 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. H 2 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 H 2 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.