The Baffling Case of a Woman Who Looks Drunk Without Ever Consuming Alcohol: How Auto-Fermentation Syndrome can Mimic Intoxication

A 50-year-old Canadian woman from Toronto has been experiencing symptoms of drunkenness, such as slurred speech, excessive sleepiness, and the smell of alcohol on her breath despite not consuming any alcohol. Despite visiting the emergency room multiple times over the course of two years and being misdiagnosed with alcohol poisoning each time, doctors were unable to find any evidence of alcohol consumption.

The woman’s family confirmed that she did not consume alcohol, leading doctors to suspect an underlying medical issue. Prior to experiencing these hangover-like symptoms, the woman had a history of recurrent urinary tract infections (UTIs) for five years, for which she was regularly prescribed antibiotics. It is believed that the antibiotics disrupted the natural balance of beneficial bacteria in her intestines, allowing harmful fungi to colonize and ferment carbohydrates, producing alcohol.

This unusual condition is known as auto-fermentation syndrome, where bacteria in the woman’s intestines ferment themselves, making her appear drunk. Auto-fermentation syndrome is a rare condition caused by fungi such as Saccharomyces cerevisiae and Candida albicans growing to high densities in the intestines and fermenting carbohydrates. People with high blood sugar levels and a poor ability to break down alcohol are more susceptible to this syndrome, which is difficult to predict due to its extreme rarity.

After being correctly diagnosed with auto-fermentation syndrome, the woman was treated with antifungal medication and advised to follow a low-carbohydrate diet to limit the fermentation process. This case highlights the importance of thorough medical evaluation and consideration of rare conditions when diagnosing unusual symptoms.