A woman’s bladder “brewed” alcohol due to a bizarre condition, a report has revealed.
The unnamed patient, 61, from the US state of Pennsylvania, was refused a life-saving liver transplant after urine tests repeatedly came back positive for alcohol.
She was accused of “hiding an alcohol-use disorder”, despite insisting she was sober.
Tests later came back negative for metabolites that get released when alcohol is broken down.
Doctors discovered the patient, who is diabetic and never appeared drunk, had microbes in her bladder that were fermenting “surplus” sugar into alcohol.
Scientists named the condition “urinary auto-brewery syndrome” or “bladder fermentation syndrome”.
Once diagnosed, the woman was reconsidered for a liver transplant. It is unclear how she is doing now.
This case is similar to the equally bizarre – but recognised – auto-brewery syndrome, which occurs when the gut converts sugary and starchy foods into alcohol.
Even eating carbohydrates or sugary foods can leave these patients “drunk”.
In the woman’s case, the alcohol produced in her bladder did not enter her bloodstream, resulting in her never becoming intoxicated.
The patient, who suffered from scarring of the liver, was told by doctors at an undisclosed hospital she needed treatment for alcohol addiction and they would not give her a transplant until she was “clean”.
It is unclear if the scarring was caused by her condition.
The woman then went to the University of Pittsburgh’s Presbyterian Hospital.
Doctors again accused her of having a substance-abuse problem, before noticing her urine tests were missing the metabolites ethyl glucuronide and ethyl sulfate.
“At least one of these should be present for several days after a person drinks alcohol”, Dr Kenichi Tamama told Live Science.
The woman’s blood tests also came back negative for ethanol, which is the principle ingredient in alcoholic beverages.
Doctors noted her diabetes was poorly controlled, leading them to wonder whether microbes in her bladder were fermenting sugar into alcohol.
To put this theory to the test, they froze a sample of the patient’s urine.
The sample was then incubated at body temperature (37°C/98°F), leading to “remarkably high levels of ethanol production”.
This did not occur when the urine was incubated at 4°C/39°F or when a fermentation-blocking chemical was added.
“We concluded the discrepant test results were best explained by yeast fermenting sugar in the bladder”, the scientists wrote in the journal Annals of Internal Medicine.
Tests also revealed the woman had the fungi Candida glabrata in her urine, a species that is “closely related” to brewer’s yeast.
Brewer’s yeast is used by beer makers to convert carbohydrates in grains into alcohol.
The woman was reportedly prescribed oral antifungal drugs to rid the fungus from her bladder.
Few reports have linked diabetics with alcohol-fermentation in that particular organ.
Those that are exist are “limited”, with one study being carried out post mortem, Live Science reported.
Auto-brewery syndrome, however, is better known.
An unnamed 46-year-old was pulled over by police in 2014, with a breathalyser showing he was five times over the legal limit.
The man claimed he had not drank a drop of alcohol, which both the police and his family refused to believe.
It was not until 2017 that doctors discovered yeast that produce alcohol had overgrown in his gut.
His condition is so rare, there is said to have been just five reported cases in the past 30 years.