Intoxication without alcohol: Auto-brewery syndrome

How can someone have alcohol intoxication without consuming alcohol? Auto-brewery syndrome, a rare condition in which intestinal fungi produce alcohol through fermentation, is described in a case study in the Journal of the Canadian Medical Association.

“Autobrewery syndrome has significant social, legal and medical consequences for patients and their loved ones,” writes Dr. Rahel Zewude, University of Toronto, along with co-authors.

“Our patient had several [emergency department] visits, was assessed by internists and psychiatrists, and was certified under the Mental Health Act before being diagnosed with autobrewery syndrome, underscoring how awareness of this syndrome is essential for clinical diagnosis and treatment.

Emergency department, gastroenterology and infectious disease specialists discuss the case of a 50-year-old woman who had visited the emergency room at least seven times due to extreme daytime sleepiness and slurred speech and, despite not drinking alcohol, an elevated alcohol content in the blood had levels and alcohol on her breath.

She had been taking several courses of antibiotics in addition to a proton pump inhibitor for recurrent urinary tract infections.

On the seventh visit, she was given a possible diagnosis of autobrewery syndrome, antifungal medications, and referral to a gastroenterologist.

Antifungal medications and low-carb diets are the main treatment for the condition.