Microbial ethanol production in postmortem urine sample

Abstract

We present a case in which postmortem blood ethanol concentration was 0.02 g/kg and acetone concentration was 0.51 g/kg, while urine ethanol concentration was 6.0 g/kg and acetone concentration was 0.63 g/kg. In the urine sample, sodium fluoride was not added. The urinary ethanol concentration continued to increase without any remarkable increase of isopropanol concentration and external contamination was excluded. Species of bacteria and yeasts, including Candida glabrata, were isolated from urine and blood samples. A few days after the collection of samples, we received the information that the patient was diabetic and did not receive insulin therapy regularly. To prevent postmortem microbial ethanol production and incorrect diagnosis of the cause of death, it is necessary to add sodium fluoride to blood and urine samples collected from diabetic patients.

Postmortem Ethanol Concentrations and Postmortem Ethanol Production

“…Several studies have shown apparent postmortem increases in ethanol concentration in the blood and urine of diabetics with high blood or urine glucose concentrations, or in persons who have received intravenous glucose, due to microbes and especially if fungus such as Candida is present (13–16). Such authors point out the need to preserve urine with sodium fluoride as is done with blood.…”

Microbial neoformation of volatiles: implications for the estimation of post-mortem interval in decomposed human remains in an indoor setting

“…Moreover, presence of fluoride ions in the blood inhibits the in vitro neoformation of ethanol [5,6]. However, case reports indicate possible in vitro formation of ethanol in spite of addition of fluoride [32,33].…”