Case Presentation: A 55-year old female with cirrhosis secondary to chronic hepatitis B infection non-adherent with Entecavir therapy presented with altered mental status, diarrhea, abdominal pain, and emesis. Vital signs revealed hypotension, tachycardia, and tachypnea. Exam revealed somnolence and significant abdominal distension without guarding, rebound, or rigidity. Laboratory evaluation was remarkable for a leukocytosis to [...]