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Auto-brewery syndrome in a 50-year-old woman
KEY POINTS A 50-year-old woman was referred to a gastroenterology clinic after 7 presentations over the previous 2 years to emergency departments (EDs) with alcohol intoxication despite her report of no alcohol consumption. Over the preceding 5 years, she had had recurrent urinary tract infections (
Notably, during her third ED visit, she received certification under the Mental Health Act(Form 1), as the treating emergency physician had concerns for self-neglect when the patient initiated discharge before psychiatry assessment. On consultation with the patient in our infectious diseases clinic, we agreed with the diagnosis of auto-brewery syndrome based on her recurrent intoxication presentations with elevated ethanol levels and consistent self- and corroborated reporting of no alcohol consumption. 8, 9 When auto-brewery syndrome is suspected, the diagnostic framework includes performing a history (from the patient and close contacts), physical examination, blood work, glucose challenge test, and microbiological assessments ( Figure 1).
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