由口腔真菌和牙周病细菌引起的自动酿酒综合征。
Auto-brewery syndrome caused by oral fungi and periodontal disease bacteria.
作者信息
Takahashi Gaku, Hoshikawa Koichi, Kan Shigenori, Akimaru Rise, Kodama Yoshiyuki, Sato Toshiro, Kakisaka Keisuke, Yamada Yuki
机构信息
Department of Critical Care, Disaster and General Medicine School of Medicine Iwate Medical University Morioka Japan.
Division of Preventive Dentistry Department of Oral Medicine School of Dentistry Iwate Medical University Morioka Japan.
出版信息
Acute Med Surg. 2021 May 3;8(1):e652. doi: 10.1002/ams2.652. eCollection 2021 Jan-Dec.
BACKGROUND
Auto-brewery syndrome (ABS) is often caused by fungi in the intestinal tract. We describe a rare case of alcohol production by and periodontal disease bacteria in the oral cavity.
CASE PRESENTATION
A man aged in his 60s had a car accident, and alcohol was detected on his breath. At the time, he exhibited alcohol overdose seizures with no alcohol consumption. We carried out a gastrointestinal endoscopy, detected esophageal candidiasis, and diagnosed ABS. His seizures continued despite using miconazole oral gel. Significant tooth decay, periodontal disease, and high levels were observed in his oral cavity. Alcohol production was confirmed from periodontal bacteria and cultures and alcohol-degrading enzyme functions were poor. Dental treatment and antifungal drugs reduced seizures, and improved his fatty liver.
CONCLUSION
Alcohol can be produced by microorganisms in healthy individuals. Therefore, blood alcohol levels and alcohol-degrading enzyme functions should be examined in patients with unexplained liver dysfunction.
背景
自动酿酒综合征（ABS）通常由肠道中的真菌引起。我们描述了一例罕见的由口腔中的牙周病细菌产生酒精的病例。
病例介绍
一名60多岁的男子发生车祸，其呼出气体中检测到酒精。当时，他在未饮酒的情况下出现了酒精过量性癫痫发作。我们进行了胃肠内镜检查，发现食管念珠菌病，并诊断为ABS。尽管使用了咪康唑口腔凝胶，他的癫痫发作仍持续。在他的口腔中观察到严重的龋齿、牙周病和高[具体指标]水平。从牙周细菌和[具体细菌名称]培养物中证实了酒精的产生，且酒精降解酶功能较差。牙科治疗和抗真菌药物减少了癫痫发作，并改善了他的脂肪肝。
结论
健康个体中的微生物可产生酒精。因此，对于原因不明的肝功能障碍患者，应检查血液酒精水平和酒精降解酶功能。
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