Too Much

A 45 year old man presents with fever, jaundice, abdominal distention, and anorexia for 4 days.

He is a heavy drinker, having consumed half a bottle of whiskey almost every day, for over a decade.

There is no history of blood transfusions, recreational drug use, or unsafe sexual contact. His medical and surgical histories are unremarkable.

Select Relevant Investigations
Complete Blood Count

Performed

WBC/DC: 11,200/mm3 (4,600-11,000)
N: 70% L: 25%
Hb: 11 g/dL (11-18)
Platelets: 180,000/mm3 (150,000-450,000)
Liver Profile

Performed

ALT: 28 IU/L (7-47)
AST: 132 IU/L (10-40)
ALP: 238 IU/L (44-147)
INR: 1.58 (0.9-1.1)
PT (Test): 19 sec
PT (Control): 12 sec
Total Bilirubin: 7 mg/dL (0.3-1.9)
Diagnostic Paracentesis

Performed

WBC/DC: 20/mm3
PMN: 70%
Gram stain: Negative
Cytology: No malignant cells
Amylase: 30 U/l (Serum Amylase: 64 U/l)
Serum Ascites Albumin Gradient: 2.0 mg/dl (transudative)
Liver Biopsy

Performed

You realize that a liver biopsy is not indicated right now.

Select Relevant Management
Benzodiazepines
Corticosteroids
Pentoxifylline
Cessation of Drinking stat