High Urine Ethanol and Negative Blood and Vitreous Ethanol in a Diabetic Woman
- 1 March 2005
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in American Journal of Forensic Medicine & Pathology
- Vol. 26 (1), 96-98
- https://doi.org/10.1097/01.paf.0000154266.15884.84
Abstract
Several studies have shown that ethanol can be produced in urine infected with yeast or bacteria in vitro. We present the unusual case of a diabetic woman in whom ethanol was produced in her urine in vivo. The decedent was a 19-year-old woman who was noncompliant with her diabetes treatment. She presented to a local hospital in severe diabetic ketoacidosis and died shortly thereafter. Upon arrival at the hospital, a blood glucose of 553 mg/dL was detected. A urinalysis was positive for ketones (> 80 mg/dL), glucose (> 1000 mg/dL), and large budding yeast forms. A drug screen performed on the urine was positive for ethanol. At the coroner/medical examiner office, an autopsy was negative for significant anatomic findings. Toxicology analysis revealed a urine ethanol level 0.32 g/dL, although no ethanol was detected in blood or vitreous samples. A urine gram stain and culture identified Candida glabrata. A retrospective case review of all deaths related to diabetes examined at the coroner/medical examiner office from 1986 to 2003 did not reveal other cases with similar findings. This case of a noncompliant, juvenile-diabetic woman illustrates a rare finding of apparent in vivo glucose fermentation by C. glabrata to form ethanol in the urine. This case also highlights a potential difficulty in toxicologic analysis and interpretation using urine only.Keywords
This publication has 6 references indexed in Scilit:
- Endogenous Ethanol ‘Auto-Brewery Syndrome’ as a Drunk-Driving Defence ChallengeMedicine, Science and the Law, 2000
- Storage of Specimens at 4 C or Addition of Sodium Fluoride (1%) Prevents Formation of Ethanol in Urine Inoculated with Candida albicansJournal of Analytical Toxicology, 1999
- The Effect of Temperature on the Formation of Ethanol by Canadida Albicans in BloodJournal of Forensic Sciences, 1989
- Urinary Ethanol and Diabetes MellitusDiabetic Medicine, 1988
- URINARY ETHANOL LEVELS AND DIABETESThe Lancet, 1981
- Ethanol Production in Infected UrineNew England Journal of Medicine, 1979