Endogenous ethanol fermentation in a child with short bowel syndrome.
The term "auto-brewery syndrome" has been frequently used to describe patients who show features of alcohol intoxication because of abnormal yeast proliferation after ingesting carbohydrate-rich meals. We present a case of a 3-y-old girl with short bowel syndrome (SBS) who demonstrated signs of alcohol intoxication on repeated occasions. A blood test indicated an ethanol concentration of 15 mmol/l, and cultures from gastric fluid and faeces showed the presence of Candida kefyr. An association was found between the introduction of a carbohydrate-rich fruit drink and the occurrence of symptoms.


CONCLUSIONS
The possibility of endogenous ethanol fermentation should be considered in patients with SBS and the diagnosis of auto-brewery syndrome added to the differential diagnosis list for D-lactic acidosis. Management includes both antifungal treatment and special diet modification.
Jansson-Nettelbladt
Evelyn
E
Section of Infectious Diseases, Department of Medical Sciences, University Hospital, Uppsala, Sweden.
Meurling
Staffan
S
Petrini
Björn
B
Sjölin
Jan
J
D001628:Beverages; D002175:Candida / Q000502:physiology; D002675:Child, Preschool; D004040:Dietary Carbohydrates / Q000378:metabolism*; D000431:Ethanol / Q000378:metabolism*; D005260:Female; D005285:Fermentation / Q000502:physiology*; D005638:Fruit / Q000378:metabolism; D006801:Humans; D012441:Saccharomyces cerevisiae / Q000502:physiology; D012778:Short Bowel Syndrome / Q000150:complications / Q000378:metabolism* / Q000382:microbiology; D013577:Syndrome
D004040:Dietary Carbohydrates; D000431:Ethanol