This 54-year-old man with a long history of alcohol abuse disorder. Three weeks prior to his demise, the patient began an alcoholic binge. Three days prior to admission the patient developed fever and malaise and when he was brought to the hospital he was semi-comatose and had a fever of 104.5°F. Shortly after arriving at the hospital, the patient died from massive pneumonia.

At autopsy, a necrotizing lobar pneumonia was present which contained organisms consistent with Klebsiella pneumoniae. The liver was enlarged--weighing 2700 grams--and had a yellow-orange color. The liver was firm to palpation and the cut surface had a slightly granular appearance suggestive of early cirrhosis. The pancreas showed multiple areas of fibrosis.