Weird patient: she urinates alcohol

You may have already spoken about the intestinal fermentation syndrome, or syndrome of auto-brewery, which we reported for 2025. An astonishing disorder that makes people drunk even when they have not drunk any drop ofalcohol. This disease, linked to yeasts developing in the intestine and transforming the glucose in ethanol, has only been reported very rarely in the medical literature. American doctors have just identified an even rarer, and even unique, case of auto-fermentation syndrome in bladder, where a patient literally urinates alcohol.

Suspected of drinking secretly

Narrated in the review Annals of Internal Medicine, this 61-year-old patient's mishap begins when she requests to be placed on a waiting list for graft of liver, because of a cirrhosis advanced and a diabetes poorly controlled. Problem: his analyzes systematically reveal very high alcohol levels in the urine, greater than 39.1 mmol / L (180 mg / dL). Rates that normally correspond to a significant and recent consumption of alcohol. Despite her repeated denials of any alcohol intake, the sixty-something woman was twice refused registration on the waiting list for transplants, the doctors advising her to follow a detoxification treatment first.

She shows no signs of drunkenness

It is initially the same hypothesis towards which the doctors of the university hospital of Pittsburgh (United States) turn, where the patient presents herself for a third attempt. But, at the insistence of the latter to deny any consumption of alcohol, doctors begin to have doubts. First, the patient shows no signs of drunkenness, where the levels of alcohol measured in her urine should make her totally drunk. Moreover, urine has no other metabolite alcohol degradation that is usually found.

Finally, doctors detect significant hyperglycosuria, with values ​​greater than 55.5 mmol / L (1,000 mg / dL). Logical for a person suffering from diabetes, but what still arouses suspicion. Especially since the analyzes also reveal the presence of yeasts in high quantity. " All these clues have led us to Review whether the yeast colonizing the bladder could ferment the sugar to produce ethanol ", Write the researchers.

A yeast that ferments sugars into alcohol in the bladder

The yeast identified, Candida glabrata, is very common in the environment and very close to brewer's yeast (Saccharomyces cerevisiae). It is naturally present in the microbial flora of the mouth, the gastrointestinal tract, vagina or from skin. Normally harmless, it can, however, cause candidiasis severe in at-risk patients when it enters the bloodstream or develops abnormally, and spreads to other parts of the body.

In the present case, the yeast that colonized the bladder ferments the sugar, present in large quantities, in ethanol, leading to a "urinary auto-fermentation syndrome", as doctors have called it. A case similar to that of intestinal auto-brewing syndrome, with the difference that the person does not suffer from intoxication here, the alcohol being simply produced in the bladder and directly excreted. Unfortunately for the sixties, the classic treatment against candidiasis, based onantifungals, has been shown to be ineffective in removing yeast. But the patient was finally put on the waiting list for her liver transplant.