Auto-brewery syndrome is a rare multifactorial disease in which endogenous alcohol production occurs due to an overpopulation of fermentable microorganisms (especially Saccharomyces cerevisiae and Candida species but also bacteria like Klebsiella pneumoniae).
Even in the healthy population, there is a low level of endogenous fermentation that is not enough to cause alcohol intoxication. The genesis of auto-brewery syndrome involves a carbohydrate-rich diet and in part a genetic predisposition, such as inefficient alcohol metabolism. In addition, there are associations with diabetes mellitus, liver diseases, gastrointestinal motility disorders, and chronic inflammatory bowel diseases.
Abstinence From Alcohol A 50-year-old patient from Toronto, presented repeatedly to the emergency department over 2 years with alcohol intoxication despite credible denial of alcohol consumption. For several years, she had not been drinking alcohol for religious reasons, a fact confirmed by her husband and son. In addition, the patient had recurring episodes of somnolence and situations where she would fall asleep during everyday activities like cooking, leading to frequent falls.
Before these episodes began, the patient had repeated urinary tract infections over about 5 years, which were treated with antibiotics (ciprofloxacin and nitrofurantoin). Due to reflux disease, she also took dexlansoprazole.
Emergency Department Visits In the emergency department, the patient presented with slurred speech and alcoholic breath. An alcohol level of up to 62 mmol/L in the blood (normal level,
Source : Medscape