1. Auto brewery syndrome overviewemerging infectious disease.
• By
• Dr.Ashok laddha
• Occupational Health
Physician
• MBBS, PGDC ,PGDD,
PGDEM, AFIH
• Diploma in Workplace
Health and safety. MBAHA(In –Progress)

2. Auto brewery Syndrome
• Auto-brewery syndrome, also known as gut
fermentation syndrome,
• a rare medical condition
• intoxicating quantities of alcohol are produced
through endogenous fermentation within the
digestive system
• Numerous cases have been documented in
the medical literature.

3. History
• Auto-brewery syndrome was not unknown
• previously been described in Japan, where it is
called “meitei-sho.”
• people of East Asian descent possess a
mutation in their liver enzymes which does
not allow them to properly process alcohol.
• relatively unknown phenomenon in modern
medicine

4. definition
• Gut Fermentation Syndrome is described as a
syndrome
whereby
patients
become
intoxicated without ingesting alcohol.
• syndrome has also been called Drunkenness
Disease
and
Endogenous
Ethanol
Fermentation.
• The underlying mechanism is thought to be an
overgrowth of yeast in the gut whereby the
yeast ferments carbohydrates into ethanol

5. Contributing factors
• heavy consumption of carbohydrate-rich food
like rice
• gastrointestinal surgery,
• taking antibiotics,
• All above factrors can wipe out the bacteria in
the stomach and make room for infestations
of yeast.

6. Causative agent
• yeast called Saccharomyces cerevisiae
• Candida albicans, Candida krusei, Candida
glabrata
• yeast caused starch to ferment sugar -ultimately producing ethanol.

7. Risk factor
• Treatment with a probiotic containing
Saccharomyces boulardii
• immunosuppressed or critically ill patients.
• probiotic is used for the treatment and
prevention of Clostridium difficile-associated
diarrhea

8. Saccharomyces cerevisiae
• Saccharomyces cerevisiae, also known as brewer’s yeast,
has a very well known history and life cycle because of the
brewing industry.
• More recently the entire genome of S. cerevisiae has been
identified due to its important use in fermenting corn into
ethanol for fuel consumption. Very little is known, however,
about the role of S. cerevisiae in humans. In fact, S.
cerevisiae has been described only recently as an
“emerging infectious disease”
• S. cerevisiae has mostly been identified as a pathogen in
critically ill patients who are immunocompromised and in
infants Not one single article could be found on an S.
cerevisiae infection in an otherwise healthy, immunocompetent adult .

9. Uses-Saccharomyces cerevisiae
• Saccharomyces cerevisiae is well known in the
baking and brewing industry
• also used as a probiotic in humans.
• However, it is a very uncommon cause of
infection in humans.

10. Symptoms
• Those of alcohol intoxication

11. Diagnostic tests
•
•
•
•
•
•
•
Gulcose and carbohydrate challenge
Fructose and lactose intolerance
Stool culture
BAC
Blood gulcose level
Blood ethanol level
Complete gastroenterology workup

12. treatment
• Antifungal – fluconazole 100 mg a day for
three weeks
• Followed by Nystatin 500,000 IU 4 times a
day-3 weeks
• Restricted carbohydrate diet
• No sugar
• No alcohol
• Treatment for H.pylori--Tetracycline

13. Importance
• This is a rare syndrome but should be
recognized because of the social implications
such as loss of job
• relationship difficulties
• stigma
• possible arrest and
• incarceration.

14. Implication
• Listen—careful and meticulos history can
clinch the diagnosis
• Occupational history
• Additional investigations
• Research on overgrowth of microbes
• Additional research on microbe

15. Take home message
• Meticulous clinical and occupational history
can clinch the diagnosis