A middle aged man w/ HCV and excessive etoh use presents with altered mental status, found to have liver failure of unclear chronicity. Already growing GNRs in blood!
*The evidence behind pharmacologic treatments for alcoholic hepatitis is shotty; a 2015 NEJM paper showed that prednisone showed trends of decreased mortality at 28 days that did not reach significance. Prednisone should not be given in the setting of suspected infection. Pentoxifylline does not improve survival. http://www.nejm.org/doi/10.1056/NEJMoa1412278