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.