In a new case study fit for Dr. House himself, a team of Canadian physicians have reported the occurrence of a rare condition that caused a 50-year-old woman to become intoxicated from alcohol fermented naturally in her own gut.
Over the past two years, the unnamed patient at the heart of the newly published case study had repeatedly visited hospital emergency departments (ED) complaining of slurred speech and extreme drowsiness, which had led to repeated falls. On each occasion, attending physicians had also noted the smell of alcohol on the woman’s breath, along with significantly heightened blood alcohol levels of 39 millimoles per litre (mmo/L) relative to the less than two mmo/L expected in a healthy, sober person.
The symptoms led to the patient being repeatedly discharged with a diagnosis of alcoholic intoxication, despite her repeatedly explaining that she had stopped drinking completely over recent years on account of religious beliefs — a claim which was backed up by her close family.
During the hospital visits, the woman was given three separate assessments by psychiatrists, wherein she was given a screening questionnaire for alcohol use disorder, on which she scored a zero, indicating a lack of addiction. Following the patient’s third ED visit, the 50-year-old was certified under the country’s Mental Health Act — allowing the individual to be detained without consent for up to 72 hours — after the emergency physician became concerned when the patient discharged herself prior to psychiatry assessment.
On her seventh visit to the ED, the attending doctor considered that the unexplained intoxication could infact have been caused by a rare, and difficult to diagnose condition known as auto-brewery syndrome. This strange biologic quirk is thought to occur when a combination of factors such as a person’s diet, and genetic predisposition cause fermenting microbes to over-colonize in the gut, leading to the creation of alcohol in the form of ethanol from carbohydrates, which is then re-absorbed by the body.
The diagnosis of auto-brewery syndrome was later backed up by the hospital’s infectious disease clinic, based on the evidence from the patient’s family, and other supporting factors.
“Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones,” said Dr. Rahel Zewude of the University of Toronto, who was one of the coauthors on the case study published in the Canadian Medical Association Journal.
“Our patient had several [emergency department] visits, was assessed by internists and psychiatrists, and was certified under the Mental Health Act before receiving a diagnosis of auto-brewery syndrome, reinforcing how awareness of this syndrome is essential for clinical diagnosis and management,” continued Dr. Zewude.
With the likely cause identified, physicians went on to prescribe the woman targeted antifungal medication, and a low carb diet to treat the condition. Following a brief recurrence of the drowsiness and slurred speech resulting from a dietary uptake in carbs, the patient is continuing the treatment, and is seemingly recovering well.
For more science news why not read up on how researchers used cold hard logic to disprove the existence of the real world counterpart of planet Vulcan from Star Trek, or discover a disturbing revelation surrounding human testicles and microplastics.
Anthony is a freelance contributor covering science and video gaming news for IGN. He has over eight years experience of covering breaking developments in multiple scientific fields and absolutely no time for your shenanigans. Follow him on Twitter @BeardConGamer
