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A New Kind of Barrel Chest: Alcoholic Fermentation due to Candida albicans in a Pleural Effusion

  • David Tobys
    Affiliations
    Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany

    German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Germany
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  • Wibke Johannis
    Affiliations
    Institute for Clinical Chemistry, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany
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  • Martin Juebner
    Affiliations
    Institute of Legal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany
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  • Hendrik Drinhaus
    Correspondence
    Requests for reprints should be addressed to Dr. med. Hendrik Drinhaus, Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Köln, Germany.
    Affiliations
    Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany
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      Pleural effusions are common in critically ill patients. They can be infected with fungi, especially in cases of gastro-esophageal perforations.
      • Ko SC
      • Chen KY
      • Hsueh PR
      • Luh KT
      • Yang PC
      Fungal empyema thoracis: an emerging clinical entity.
      If yeasts and sugar-containing fluids come together in the body, alcohol can be produced. This phenomenon, called auto-brewery syndrome, has been described in the intestinal or urinary system.
      • Sulkowski HA
      • Wu AH
      • McCarter YS
      In-vitro production of ethanol in urine by fermentation.
      ,
      • Spinucci G
      • Guidetti M
      • Lanzoni E
      • Pironi L
      Endogenous ethanol production in a patient with chronic intestinal pseudo-obstruction and small intestinal bacterial overgrowth.
      We hypothesized that alcohol can develop in a yeast-infected pleural effusion.
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      References

        • Ko SC
        • Chen KY
        • Hsueh PR
        • Luh KT
        • Yang PC
        Fungal empyema thoracis: an emerging clinical entity.
        Chest. 2000; 117: 1672-1678
        • Sulkowski HA
        • Wu AH
        • McCarter YS
        In-vitro production of ethanol in urine by fermentation.
        J Forensic Sci. 1995; 40: 990-993
        • Spinucci G
        • Guidetti M
        • Lanzoni E
        • Pironi L
        Endogenous ethanol production in a patient with chronic intestinal pseudo-obstruction and small intestinal bacterial overgrowth.
        Eur J Gastroenterol Hepatol. 2006; 18: 799-802