Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, University of Pittsburgh School of Medicine, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania (K.T.)

Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (A.W.P.)

Background: Auto-brewery syndrome is a rare medical condition in which intoxicating quantities of ethanol are produced by specific types of yeast or bacteria through endogenous fermentation in the digestive system (1).

Objective: To alert clinicians to the possibility of a previously unrecognized auto-brewery syndrome in which ethanol is produced through endogenous fermentation in the urinary system.

Case Report: A 61-year-old woman with cirrhosis and poorly controlled diabetes presented to our center for placement on the liver transplant waitlist. Previously, clinicians at another hospital advised her to obtain treatment for alcohol addiction instead of placing her on their center's liver transplant ...