Domino effect: An unusual case of six fatal hydrogen sulfide poisonings in quick succession

Barbera, Nunziata; Montana, Angelo; Indorato, Francesca; Arbouche, Nadia; Romano, Guido

doi:10.1016/j.forsciint.2016.01.021

Cited by 23 publications

(13 citation statements)

References 11 publications

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“…Patients suffering from high concentrations of hydrogen sulfide poisoning present "lightning-like" death (Anantharam et al, 2017). Past case reports (Barbera et al, 2016;Park et al, 2009) have described autopsy results due to hydrogen sulfide poisoning to include changes in the organ color of the brain, skin, liver, and pulmonary edema. In our case reports, case 2 patient survived while case 1 patient died.…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial injury following hydrogen sulfide poisoning

Shen

Huang

et al. 2020

Toxicol Ind Health

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Background: Hydrogen sulfide poisoning can cause severe myocardial injury, but the damage is subtle and can be easily misdiagnosed. This report presents the dynamic observation of myocardial injury associated with hydrogen sulfide poisoning. Case report: Two young men presented with symptoms of “lightning-like” death immediately after entering a tank. They were found and rescued in 20 min at a time when they were already in a coma. Case 1 had no spontaneous breathing and pulse, while case 2 had spontaneous breathing and a pulse. Upon transfer to a local hospital, case 1 received continuous cardiopulmonary resuscitation which led to the recovery of his heart rate 3 min after arriving at the hospital. However, the patient remained in a Glasgow coma scale of 3. He was transferred to our hospital where he, unfortunately, died on the seventh day due to multiple organ failure. Case 2 was also transferred to the intensive care unit in our hospital and on the fourth day of hospitalization, the patient presented ST-segment elevation and dynamic changes in markers of myocardial injury. Changes in electrocardiogram and markers of myocardial injury were monitored and examination improved through conventional echocardiography, coronary artery CT, radionuclide myocardial perfusion imaging, and two-dimensional speckle tracking imaging strain. The treatment gradually improved the patient’s myocardial injury and was discharged from the hospital. Conclusion: Hydrogen sulfide poisoning can cause damage to myocardial function and the damage can be more insidious in nature and with a delayed onset. Recovery from myocardial damage can be very slow.

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Section: Discussionmentioning

confidence: 99%

Acute myocardial injury following hydrogen sulfide poisoning

Shen

Huang

et al. 2020

Toxicol Ind Health

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“…Death by H 2 S intoxication is therefore caused by a direct pulmonary effect and a neurotoxic effect on the cerebral respiratory centre, both of which lead to acute respiratory failure, respiratory acidosis and then to cardiac arrest. [18][19][20][21] Moreover, there is evidence that H 2 S may cause a shift to anaerobic cellular metabolism which can be explained by the H 2 S inhibiting the action of cytochrome c oxidase, which paralyses the electron transport system. In addition to the hypoxia caused by H 2 S binding to haemoglobin, the inhibition of cytochrome c oxidase causes a cellular switch to anaerobic metabolism and the accumulation of lactate.…”

Section: Discussionmentioning

confidence: 99%

“…However, the bodies of victims in some cases of death by acute H 2 S intoxication are described as showing a diffuse green discolouration of the skin and internal organs in the published literature. 18,19 This is due to the early formation of sulfhaemoglobin and other pigments similar to the products of putrefactive bacterial metabolism. However, other signs of advanced putrefaction are not present in these cases probably due to the short interval between the times of death and autopsies.…”

Section: Discussionmentioning

confidence: 99%

The role of ethanethiol in deaths from acute poisoning by gas mixtures: A suicide case involving a decomposed corpse and a review of the literature

et al. 2020

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The most common volatile substances used in suicide are liquefied petroleum gas mixtures, which consist of propane and butane gases mixed in different proportions. These substances are odourless and colourless. Some substances, such as ethanethiol, are added to liquefied petroleum gas mixtures to provide a garlic scent. The main causes of death in acute liquefied petroleum gas inhalation are cardiac arrest and asphyxia, but determining the manner of death is difficult. We present a case of a 30-year-old man found dead at home. On his head was a black plastic bag with a hole through which he had run a gas hose connected to a domestic liquefied petroleum gas cylinder tank. Toxicological analysis revealed butane and ethanethiol in his body. This study aims at understanding the lethal role of ethanethiol through the analysis of its chemical action and its influence on decomposition.

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“…Six cases of fatal H2S poisonings were examined at the Department of Forensic Toxicology at the University of Catania, Italy . Complete autopsies were performed c .…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the Role of Toxicological Data in Discriminating Between H₂S Femoral Blood Concentration Secondary to Lethal poisoning and Endogenous H₂S Putrefactive Production

Barbera

Montana

Indorato

et al. 2016

Journal of Forensic Sciences

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Hydrogen sulfide is a colorless gas and has a strong odor of rotten eggs. It is absorbed by the upper respiratory tract mucosa, and it causes histotoxic hypoxemia and respiratory depression by exerting an inhibitory effect on cytochrome oxidase. To evaluate the role of toxicological data in distinguishing between the H S blood concentration secondary to lethal poisoning and the endogenous H S produced during putrefaction, we compared the postmortem H S concentrations of six fatal H S poisoning cases (8.7-28.6 mg/L) with the postmortem concentrations of endogenous H S of 12 subjects who died from other causes (traffic-related deaths) (2.2-32.7 mg/L). These results will be of interest to the forensic community as it underlines the importance of considering circumstantial evidence along with the toxicological and pathological findings in the identification of H S lethal poisoning.

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Domino effect: An unusual case of six fatal hydrogen sulfide poisonings in quick succession

Cited by 23 publications

References 11 publications

Acute myocardial injury following hydrogen sulfide poisoning

Acute myocardial injury following hydrogen sulfide poisoning

The role of ethanethiol in deaths from acute poisoning by gas mixtures: A suicide case involving a decomposed corpse and a review of the literature

Evaluation of the Role of Toxicological Data in Discriminating Between H₂S Femoral Blood Concentration Secondary to Lethal poisoning and Endogenous H₂S Putrefactive Production

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Domino effect: An unusual case of six fatal hydrogen sulfide poisonings in quick succession

Cited by 23 publications

References 11 publications

Acute myocardial injury following hydrogen sulfide poisoning

Acute myocardial injury following hydrogen sulfide poisoning

The role of ethanethiol in deaths from acute poisoning by gas mixtures: A suicide case involving a decomposed corpse and a review of the literature

Evaluation of the Role of Toxicological Data in Discriminating Between H2S Femoral Blood Concentration Secondary to Lethal poisoning and Endogenous H2S Putrefactive Production

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Evaluation of the Role of Toxicological Data in Discriminating Between H₂S Femoral Blood Concentration Secondary to Lethal poisoning and Endogenous H₂S Putrefactive Production