A 50-year-old woman was diagnosed with alcoholism after being admitted to the hospital seven times for excessive fatigue and slurred speech.
She claimed not to have been drinking, but the diagnosis of intoxication was given to her because of a unique illness known as “auto-brewery syndrome,” the illness causes intestinal fungus to ferment alcohol.
According to researchers, understanding this illness is crucial for an accurate diagnosis and effective treatment because it has social, legal, and health repercussions. The woman had been to the emergency room for more than two years, complaining of excessive daily tiredness and slurred speech.
Her history included multiple rounds of antibiotics for recurrent UTIs along with a proton pump inhibitor to lower stomach acid.
She did not drink alcohol, but she did have alcohol on her breath and high blood alcohol levels. Despite her family’s confirmation that she had never consumed alcohol, the woman was diagnosed with alcohol intoxication and released from the hospital after each visit.
After every incident, the patient required up to two weeks off work, and she fasted during this period. Her symptoms would subside after a week or two, but they would recur every two months.
After the mother discharged herself without first undergoing a mental assessment, the doctor became concerned about her self-neglect and even granted her a certificate under the Mental Health Act on the third visit.
On the seventh visit, however, the emergency physician suspected auto-brewery syndrome and, after prescribing some medication, referred her to a specialist.
Following a one-month course of an antifungal drug and a low-carb diet recommended by a dietician, the woman’s symptoms disappeared and did not return for four months.
After a month of gradually resuming her carbohydrate intake, the woman experienced a relapse of slurred speech and fatigue, which ultimately resulted in a fall.
Her symptoms disappeared once it was suggested that she resume the low-carb diet. According to Dr. Rahel Zewude of the University of Toronto and her co-authors for the Canadian Medical Association Journal said: “Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones.
“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.”
