The curious case of Auto Brewery Syndrome.
A 46-year-old North Carolina man spent years with unexplained bouts of depression, unexplained aggression, and feeling drunk after eating. He suffered a head injury from a drunken fall. He was arrested for driving while intoxicated on the way to work one morning and his blood-alcohol level was more than twice the legal limit.
The puzzling fact is that he hadn’t been drinking.
He spent seven years suffering from these bizarre symptoms before researchers correctly diagnosed his condition as auto-brewery syndrome.
The problems began in 2011 where he suffered a severe thumb injury. He took a three-week course of antibiotics while working construction on mold-infested houses. The disruption to his digestive bacteria allowed an opportunistic strain of brewers yeast to take up residence in his gut, turning any starchy meals into alcohol.
He wasn’t having a beer with his pizza, he was making beer with his pizza.
The treatment was difficult. The first attempt was a course of anti-fungal medication. This failed.
After 10 days, as his symptoms did not improve, so this dose was increased to 200 mg per day, and the patient became completely asymptomatic. Unbeknownst to us, he ate pizza and drank soda while on this treatment, resulting in a severe ABS relapse.
The next attempt was more aggressive.
We then decided to treat him with intravenous micafungin 150 mg per day for 6 weeks. … At this time, no fungal growth was present. The patient monitored his breath alcohol levels two times a day throughout the treatment process with instructions to inform us immediately if positive.
So far, this round of treatment appears successful. The case report indicates that he has shown no further symptoms for over a year.