Woman diagnosed with rare condition after doctors said she was just drunk

A woman discharged from hospital seven times for being drunk actually had a rare condition that gave the appearance that she was intoxicated.

Despite telling doctors she hadn't been drinking, medical professionals found elevated levels of alcohol in her blood and on her breath.

She was eventually diagnosed with auto-brewery syndrome (ABS), a condition which sees fungi in the gut create alcohol through fermentation.

Researchers say awareness of this syndrome, which can have serious consequences for sufferers, is essential for proper diagnosis and management.

Over two years the woman visited the emergency department complaining of extreme daytime sleepiness and slurred speech.

She had been on several antibiotic courses for recurrent urinary tract infections alongside a proton pump inhibitor to reduce the amount of acid in her stomach.

After each hospital visit the woman was discharged with the diagnosis of alcohol intoxication, despite her reports of no alcohol intake, which her family confirmed.

The patient, who is a mother, needed up to two weeks off work after each episode, during which she ate very little.

Her symptoms would get better after one to two weeks, but would return every couple of months.

On the third visit, she was even certificated under the Mental Health Act, as the doctor had concerns for self-neglect when she discharged herself before psychiatric assessment.

However, at her seventh visit the emergency doctor considered a diagnosis of auto-brewery syndrome, and after being prescribed medication, she was referred to a specialist.

A dietitian suggested a low-carbohydrate diet, and after completing a one-month course of an antifungal medication and the diet, the woman’s symptoms went away and remained absent for four months.

The woman slowly started to eat carbohydrates again, but one month after doing so she had a recurrence of slurred speech and drowsiness, which led to a fall.

She was advised to restart the low-carbohydrate diet again, and her symptoms resolved.

Writing in the Canadian Medical Association Journal, Dr Rahel Zewude, University of Toronto, and her co-authors, 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.”

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