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After observing oxygen desaturation and onsite detection of hydrogen sulfide (H2S), the patient arrived with stable vital signs and arterial blood gas findings; pulmonary edema was diagnosed on CT. Treatment with hyperbaric oxygen (HBO) and methylprednisolone led to rapid improvement in oxygenation by day 2, followed by discontinuation of oxygen and steroids and discharge on day 5. The report discusses mechanisms, thresholds, and the uncertain role of corticosteroids, emphasizing recovery without sequelae after combined therapy.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-case-of-pulmonary-edema-due-to-hydrogen-sulfide-poisoning/460403/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-case-of-pulmonary-edema-due-to-hydrogen-sulfide-poisoning/460403.png","ImageObject",300,407,{"name":92,"@type":93},"CatatanPagi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What event preceded the patient’s pulmonary edema?","Question",{"text":112,"@type":113},"The patient lost balance and fell backward while drying a sludge tank, after which rescuers provided chest compression and oxygen saturation later declined.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was pulmonary edema diagnosed and what were key findings?",{"text":117,"@type":113},"Pulmonary edema was diagnosed using computed tomography, after onsite hydrogen sulfide detection and arterial blood gas testing under oxygen therapy.",{"name":119,"@type":110,"acceptedAnswer":120},"What treatment led to marked improvement, and when was discharge?",{"text":121,"@type":113},"Combined hyperbaric oxygen therapy and methylprednisolone were used; oxygenation improved by day 2, steroids and oxygen were stopped, and the patient was discharged on day 5.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460403,1790758396,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":24,"preview_page_count":4},962090894170,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Letters to Editor  \nA Case of Pulmonary Edema due to Hydrogen Sulfide Poisoning  \nDear Editor,  \nA 23-year-old male patient experienced a sudden loss of balance, resulting in a backward fall while undertaking the task of drying a sludge tank. A staff member who was observing the incident performed chest compression. Following approximately ten times of chest compressions, the patient initiated movement. Subsequently, the same staff also fainted, prompting another employee to call an ambulance, which resulted in the rescue of both individuals.Approximately 30 min after the initial emergency medical technicians’ contact, a decline in percutaneous oxygen saturation levels (SpO2) was observed. The administration of oxygen was initiated. On‑site inspection detected hydrogen sulfide (H₂S). The patient’s vital signs on arrival were as follows: Glasgow Coma Scale E3V5M6, blood pressure 119/90 mmHg, pulse rate 90 beats per minute, respiratory rate 16 breaths per minute, and body temperature 36.4°C. A physical examination yielded no significant findings. A 12-lead electrocardiogram showed no changes in the ST segment. The arterial blood gas analysis under oxygen 15 L/min yielded the following results: pH 7.362, paCO₂ 41.5 mmHg, paO₂ 76.2 mmHg, HCO₃– 23.0 mol/L, and base excess– 1.9 mmol/L. The diagnosis of pulmonary edema was made on computed tomography (CT) [Figure 1]. The patient was treated by hyperbaric oxygen (HBO) and methylprednisolone 1 mg/kg. On the 2nd day, the patient exhibited a paO2 level of 319 mmHg, with 10 Lof oxygen per minute. Concurrently, the administration of oxygen and methylprednisolone was discontinued. He was discharged on the 5th day of his illness.  \nTo our knowledge, this is the first documented case of H₂S-induced pulmonary edema with marked improvement without sequelae  \nfollowing combined HBO and steroid therapy. Exposure to H₂S above a threshold value of 200–300 ppm is associated with the sudden onset of hemorrhagic pulmonary edema.[1] With regard to investigations on toxic mechanisms, a key tight junction protein in the vascular endothelium was found tobe decreased.[2] Respiratory tract irritation constitutes an additional mechanism. It has been demonstrated that HBO therapy appears to result in the elimination of H2S from the mitochondrial cytochrome oxidase.[3] In addition, HBO has been observed to counteract the reduction in oxygen transport capacity caused by methemoglobinemia. Furthermore, the therapy has been shown to reduce cell edema.[4] Recently, for a case of H2S intoxication, nitrite was administered intravenously initially. However, the anticipated alleviation of symptoms did not materialize. Nevertheless, following HBO therapy, a marked alleviation of symptoms was immediately observed, similar to our case.[1]  \nConversely, the efficacy of corticosteroids in the treatment of pulmonary edema following human exposure to lung‑damaging agents remains uncertain. However, experimental studies on animals have demonstrated the efficacy of steroids in addressing acute lung injury induced by H2S.[5] In this particular instance, it remains ambiguous whether the efficacy was attributable to HBO or to the administration of steroids alone, or whether the observed outcomes resulted from a synergistic effect. Consequently, further investigation is imperative as additional cases accrue in the future.  \nResearch quality and ethics statement  \nThe authors followed applicable EQUATOR Network ([https://](https://)  \n 200 Journal of Emergencies, Trauma, and Shock ¦ Volume 18 ¦ Issue 4 ¦ October-December 2025   \nLetters to Editor  \nFigure 1: Chest computed tomographic image (CT) on arrival. The diagnosis of pulmonary edema was made on the basis of diffuse frosted shadows in the bilateral lungs on the CT  \n[www.equator-network.org/](www.equator-network.org/)) guidelines, notably the CARE guideline, during the conduct of this report.  \nDeclaration of patient consent  \nThe authors certify that they have obtained all a","cbCainJRDWRRvanN","https://ap.wps.com/l/cbCainJRDWRRvanN","pdf",461800,"English","# Case description\n## Clinical course and diagnosis\n## Treatment and outcome\n# Discussion\n## Toxic mechanisms and HBO rationale\n## Role of corticosteroids\n# Research quality and ethics","[{\"question\":\"What event preceded the patient’s pulmonary edema?\",\"answer\":\"The patient lost balance and fell backward while drying a sludge tank, after which rescuers provided chest compression and oxygen saturation later declined.\"},{\"question\":\"How was pulmonary edema diagnosed and what were key findings?\",\"answer\":\"Pulmonary edema was diagnosed using computed tomography, after onsite hydrogen sulfide detection and arterial blood gas testing under oxygen therapy.\"},{\"question\":\"What treatment led to marked improvement, and when was discharge?\",\"answer\":\"Combined hyperbaric oxygen therapy and methylprednisolone were used; oxygenation improved by day 2, steroids and oxygen were stopped, and the patient was discharged on day 5.\"}]","A Case of Pulmonary Edema due to Hydrogen Sulfide Poisoning | PDF"]