Microorganisms existing in blood or urine samples may produce ethanol via fermentation of sugars that are present in the specimen. The mechanism of post-collection fermentation in a urine or blood specimen is the same mechanism that is exploited to produce alcoholic beverages. The microorganisms may be introduced to the sample through non-sterile collection procedures or if the donor has a genitourinary infection, commonly Candida albicans. The likelihood of post-collection formation of ethanol through fermentation goes up during warm summer months, as samples may sit at outdoor ambient temperatures during their transport to the laboratory. Similar to poppy seed ingestion resulting in a positive test for morphine, a positive alcohol result in a sample that underwent fermentation is a true positive result. Samples can be checked for glucose by a simple "dipstick" test. The medical history of the donor should also be investigated.

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