Opinion Review
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jun 9, 2025; 14(2): 101587
Published online Jun 9, 2025. doi: 10.5492/wjccm.v14.i2.101587
Sepsis in liver failure patients: Diagnostic challenges and recent advancements
Ramesh Kumar, Abhishek Kumar, Sudhir Kumar
Ramesh Kumar, Abhishek Kumar, Sudhir Kumar, Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, Bihar, India
Author contributions: Kumar R and Kumar A designed the concept, collected the data and wrote the manuscript research study; and Kumar S collected the data and wrote the manuscript. All authors have read and approved the final manuscript.
Conflict-of-interest statement: None of authors have any conflict of interest to declare pertaining to this submission.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ramesh Kumar, MBBS, MD, Additional Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Phulwari Sharif, Patna 801507, Bihar, India. docrameshkr@gmail.com
Received: September 19, 2024
Revised: January 19, 2025
Accepted: February 12, 2025
Published online: June 9, 2025
Processing time: 160 Days and 17.6 Hours
Core Tip

Core Tip: Patients with liver failure (LF) are prone to bacterial sepsis due to immune dysregulation. Up to 80% of such patients develop bacterial infection, which is associated with various complications and poor outcomes. Therefore, it is imperative to diagnose bacterial sepsis at the earliest. However, differentiating between patients with and without sepsis can be challenging, as LF itself can mimic sepsis by inducing systemic inflammation and organ failure. Several novel biomarkers for sepsis and machine learning techniques are being investigated, as conventional biomarkers have shown inconsistent results in LF patients. This article addresses the magnitude, impact, challenges, and recent developments in understanding bacterial sepsis in LF patients.