"Death may come on like a stroke of lightening": phenomenological and morphological aspects of fatalities caused by manure gas.

Due to the decomposition of biological material, hydrogen sulphide (H2S) is produced. In low concentrations, the well-known smell of "rotten eggs" is associated with H2S. In higher concentrations, H2S is an odourless and colourless gas that may cause rapid loss of consciousness, neurological and respiratory depression and imminent death--"... like a stroke of lightening". Hydrogen sulphide poisoning is an un-common incident that is often associated with colleague fatalities. In this study, 4 fatal accidents with 10 deceased victims are reported and the morphological and phenomenological aspects are presented. In these cases, the morphological findings, namely, discolouration of the livores, pulmonary pathologies and sub-mucosal or sub-serosal congestion bleeding were found in nearly all cases. Also the impending threat for colleagues, first aid helpers and professional rescue teams is demonstrated. The suspicion of a fatal H2S intoxication should be based on a precise scene analysis with respect to the possibility of life-threatening H2S intoxication for the helpers, the typical scent of rotten eggs, which may be noted on the corpses and the abovementioned morphological findings. The diagnosis should be confirmed by a qualitative and, if possible, quantitative analysis of H2S.