Answer Clinical Challenge 2

The correct answer is Intra gastrointestinal alcohol fermentation syndrome, also called auto-brewery syndrome. This boy’s blood ethanol level checked in the most recent presentation was high. The boy denied any intake of alcohol. He was admitted and kept under strict observation. Still he continued to have bizarre behaviour and his blood ethanol levels were high on those occasions. A strong correlation between high ethanol levels and consumption of foods containing high carbohydrates was noted. He had upper gastrointestinal endoscopy and culture of duodenal aspirates showed Candida and Saccharomyces. After antifungal treatment his symptoms resolved completely.