Case Report: Acute-on-Chronic Liver Failure: Making the Diagnosis between Infection and Acute Alcoholic Hepatitis

Semin Liver Dis. 2016 May;36(2):181-6. doi: 10.1055/s-0036-1583203. Epub 2016 May 12.

Abstract

Acute-on-chronic liver failure (ACLF) represents a reversible syndrome associated with high short-term mortality, characterized by acute decompensation in patients with chronic liver disease and extrahepatic organ failure. Diagnosis and prognosis assessment is based on a newly developed diagnostic score, the Chronic Liver Failure Consortium Organ Failure score. Susceptibility to infections and systemic inflammation are typical triggers. The authors report a case in which a patient with alcohol-related cirrhosis was admitted to the hospital with acute decompensation and developed ACLF during hospitalization. This case led to an evaluation of the underlying process causing ACLF: infection versus acute alcoholic hepatitis.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / complications
  • Acute-On-Chronic Liver Failure / diagnosis*
  • Acute-On-Chronic Liver Failure / drug therapy
  • Acute-On-Chronic Liver Failure / etiology
  • Acute-On-Chronic Liver Failure / pathology
  • Administration, Intravenous
  • Anti-Bacterial Agents / administration & dosage
  • Bacterial Infections / diagnosis*
  • Diagnosis, Differential
  • Hepatitis, Alcoholic / diagnosis*
  • Humans
  • Liver Cirrhosis, Alcoholic / complications
  • Male
  • Middle Aged
  • Organ Dysfunction Scores*
  • Radiography
  • Severity of Illness Index
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents