A Positive Urine Alcohol with Negative Urine Ethyl-Glucuronide.

Urine ethanol is a common finding in urine drug-screening results. An unexpected finding of alcohol in urine can have serious implications for patients who have committed to pain-management contracts or are being counseled for substance abuse. Although laboratory screening for urine ethanol is highly specific and sensitive, the source of the ethanol can sometimes be unclear. This case report describes a 44-year-old Caucasian man with positive urine ethanol results who reported having abstained from alcohol. A test for urine ethyl-glucuronide and ethyl sulfate was used to validate the information in the patient history stating that the patient had not consumed alcohol for 1 year. Evaluation of the urinalysis results from the patient revealed fermentation in the context of glucosuria as the source of the urine ethanol.