背景:尽管念珠菌是一种预期的遭遇,并且在患有富含葡萄糖的尿液的不受控制的糖尿病中不应该令人惊讶,泌尿自动啤酒厂很少被糖尿病学家想到。此外,人类从肠道微生物组产生内源性乙醇,泌尿道真菌和细菌,和中间新陈代谢,已经被报道了很长时间,尤其是糖尿病患者。病例描述:提醒医生注意内源性乙醇作为糖尿病控制不良的生物标志物和复杂因素的被忽视的含义。我们报道了一例老年男性吸烟者戒酒胰岛素依赖型2型糖尿病患者。因为间接治疗和一周不遵守规定,他发展了内源性酒精中毒。我们提出了来自病例史的念珠菌泌尿自酿证据,尿液分析,和文化/鉴定测试-不排除其他来源。幸运的是,他的饮食和血糖控制得到了相当的控制,肝肾功能几乎正常。两性霉素BI/V五天,胰岛素,液体治疗方案大大改善了病例,并从尿液和血液中清除了念珠菌和乙醇,患者恢复了基线正常生活。结论:在未控制的糖尿病患者中,应预期会出现酒精中毒的症状,这些患者通常与念珠菌和/或便秘有关。在那些已经患有一定程度的痴呆和/或精神病/神经系统疾病的患者中,这些症状可能会被夸大。在相差显微镜下对尿液进行直接湿法安装检查会显示出芽的酵母细胞。适当的抗真菌药,胰岛素和液体治疗恢复了基线标准.
Background: Although candiduria is an expected encounter and should not be surprising in uncontrolled diabetes with glucose-enriched urine, urinary auto-brewery is rarely thought of by diabetologists. Moreover, endogenous ethanol production in humans from gut microbiome, urinary tract fungi and bacteria, and intermediary metabolism, has been reported for a long time, particularly in diabetics.
Case description: To alert physicians to the overlooked implication of endogenously produced ethanol both as a biomarker for poor control of diabetes and as a complicating factor, we report this
case of an elderly male smoker alcohol-abstinent insulin-dependent Type 2 diabetic patient. Because of circumstantial treatment and incompliance for one week, he developed endogenously produced alcohol intoxication. We proposed candidal urinary auto-brewery evidence sourced from the
case history, urinalysis, and culture/identification tests - without excluding other sources. Fortunately, his diet and glycemic control were fairly controlled and, liver and kidney functions were almost normal. Amphotericin B I/V for five days, insulin, and a fluid therapy regimen greatly improved the
case and cleared both the candiduria and ethanol from the urine and blood and the patient regained his base-line normal life. Conclusion: Symptoms of alcohol intoxication should be expected in patients with uncontrolled diabetes that most often correlates with candiduria and/or constipation. These symptoms can be exaggerated in those already suffering a degree of dementia and/or comorbid psychiatric/neurologic affections. Direct wet mount examination of urine under phase contrast microscopy would show the budding yeast cells. Appropriate antifungal, insulin and fluid therapies regained the base-line norms.