Acute-on-chronic liver failure following pneumonia in an elderly woman with metabolic dysfunction-associated steatotic liver cirrhosis.
Luyi Yao, Kunimichi Saeki, Akane Tange et al.
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Case in brief
A woman in her 80s with cirrhosis associated with metabolic dysfunction-associated steatotic liver disease developed prolonged acute-on-chronic liver failure (ACLF) triggered by pneumonia. During her admission, she also developed spontaneous bacterial peritonitis and aspiration pneumonia, with acute respiratory failure. She recovered after intensive care that included steroid treatment and antibiotics, and was discharged on Day 45. The report describes recovery without liver transplantation after the infection events were controlled.
What made this case unusual
Despite advanced age and prolonged ACLF complicated by multiple infections and acute respiratory failure, the patient recovered without liver transplantation.
Diagnostic / clinical pearl
In this case, careful management of infection and respiratory failure accompanied recovery from ACLF in an elderly patient with MASLD-associated cirrhosis.