ACUTE OCCUPATIONAL HYDROGEN SULFIDE POISONING IN A CONFINED SPACE: REPORT OF TWO CASES

Hydrogen sulfide (H2S) is a highly toxic gas commonly encountered in sanitation systems and certain industrial settings [1,2]. Acute poisoning occurs mainly in occupational settings and constitutes a medical emergency due to the rapid onset of neurological and respiratory complications, whose severity depends on gas concentration and exposure duration [3,5]. We report two cases of accidental H2S poisoning in confined spaces among sanitation workers. Both patients were admitted to the emergency department with altered consciousness and respiratory distress, requiring endotracheal intubation and mechanical ventilation. Chest imaging revealed bilateral pulmonary lesions compatible with toxic lung injury. Both patients experienced favorable outcomes under supportive treatment. Diagnosis is based primarily on occupational exposure history and clinical presentation, complemented by laboratory and imaging studies to assess respiratory involvement and gas exchange impairment [6,7]. Management is mainly supportive,including rapid removal from the toxic environment, early oxygen therapy, and ventilatory support. The use of specific antidotes remains controversial, and their availability is limited [9]. These observations underscore the importance of preventing occupational exposure to H2S, early recognition of this potentially lethal poisoning, and prompt initiation of appropriate management to improve prognosis [11].