Symptoms of mucosal irritation of the upper respiratory tract

Introduction Upper respiratory tract mucosal irritation is common in hydrogen sulfide poisoning. Hydrogen sulfide is a colorless gas that is irritating and asphyxiating. Low-concentration exposure only has local irritation of the respiratory tract and the eye. At high concentrations, the systemic effect is more obvious, manifesting as central nervous system symptoms and asphyxia symptoms. Hydrogen sulfide has a "smelly egg-like" odor, but very high concentrations quickly cause olfactory fatigue without feeling its taste. Mining, smelting, sugar beet making, carbon disulfide, organophosphorus pesticides, and hydrogen sulfide production in industries such as leather, sulphur dyes, pigments, animal glues, etc.; organic waste sites such as marshes, gutters, septic tanks, and sediments A large amount of hydrogen sulfide can escape during operation in the pool, etc. It is not uncommon for workers to be poisoned.

Cause

Hydrogen sulfide enters the body through the respiratory tract, dissolves quickly after contact with the water in the respiratory tract, and combines with sodium ions to form sodium sulfide, which has a strong stimulating effect on the eye and respiratory mucosa. After absorption of hydrogen sulfide, it mainly acts on cytochrome oxidase and disulfide bond (-SS-) in the respiratory chain, affecting the cell oxidation process and causing tissue hypoxia. When inhaled at a very high concentration, it strongly stimulates the carotid sinus and reflexively causes respiratory arrest; it can also directly paralyze the respiratory center and immediately cause asphyxia, resulting in "electric shock" death.

an examination

Related inspection

Lung imaging lung examination lung and pleural auscultation

According to the concentration and time of inhaled hydrogen sulfide, the clinical manifestations vary. Light is mainly caused by irritation, which is characterized by tearing, eye irritation, salivation, burning sensation in the throat, or symptoms such as headache, dizziness, fatigue, and nausea. Check visible conjunctival hyperemia, lung can have dry rales, can be recovered in a short period of time after dissociation; moderate poisoning, mucous membrane irritation, exacerbation, cough, chest tightness, blurred vision, conjunctival edema and corneal ulcer; , dizziness and other symptoms, and mild disturbance of consciousness, the lungs smell dry or wet rales. X-ray films showed enhanced lung texture or flaky shadows; severe poisoning showed coma, pulmonary edema, respiratory and circulatory failure, and "lightning death" may occur when inhaled at very high concentrations (above 1000 mg/m3). Severe poisoning can leave nerve and mental sequelae.

Differential diagnosis

Differential diagnosis of upper respiratory mucosal irritation:

It should be differentiated from acute poisoning, acute cerebrovascular disease, myocardial infarction, etc., such as carbon monoxide or cyanide. It also needs to be differentiated from asphyxiation by entering an environment containing high concentrations of methane or nitrogen to cause oxygen deficiency in the air. Other symptoms should also be differentiated from similar illnesses caused by other causes or trauma caused by falls after coma. According to the concentration and time of inhaled hydrogen sulfide, the clinical manifestations vary. Light is mainly caused by irritation, which is characterized by tearing, eye irritation, salivation, burning sensation in the throat, or symptoms such as headache, dizziness, fatigue, and nausea. Check visible conjunctival hyperemia, lung can have dry rales, can be recovered in a short period of time after dissociation; moderate poisoning, mucous membrane irritation, exacerbation, cough, chest tightness, blurred vision, conjunctival edema and corneal ulcer; , dizziness and other symptoms, and mild disturbance of consciousness, the lungs smell dry or wet rales. X-ray films showed enhanced lung texture or flaky shadows; severe poisoning showed coma, pulmonary edema, respiratory and circulatory failure, and "lightning death" may occur when inhaled at very high concentrations (above 1000 mg/m3). Severe poisoning can leave nerve and mental sequelae.

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