Drunk Without Drinking: A Case of Auto-Brewery Syndrome.

Information on auto-brewery syndrome is limited in the medical literature. This rare syndrome occurs when yeast overgrowth leads to ethanol fermentation in the gut. We present a patient presenting with symptoms of alcohol intoxication with objective laboratory data of elevated blood ethanol levels without a history of alcohol consumption.

Anaphylactic reaction to ethylene oxide in a hemodialysis patient.

We present the case of a patient who developed a severe systemic allergic reaction during initiation of hemodialysis. The reaction completely resolved by switching the dialysis filter sterilized by ethylene oxide to a steam sterilized filter. Ethylene oxide is used to sterilize heat sensitive medical devices, and although allergic reactions related to ethylene oxide have been reported before, awareness is lacking among providers in the inpatient setting, specifically in the intensive care unit setting.

Follow-up Blood Cultures in Gram-Negative Bacteremia: Are They Needed?

Background: Bloodstream infections remain a major cause of morbidity and mortality. Gram-negative bacilli (GNB) bacteremia is typically transient and usually resolves rapidly after the initiation of appropriate antibiotic therapy and source control. The optimal duration of treatment and utility of follow-up blood cultures (FUBC) have not been studied in detail.