Case Report: Herbal nutritional intervention in a critically ill ALS patient with multidrug-resistant infection

We report a retrospective single case of a female patient with a 9-year history of amyotrophic lateral sclerosis (ALS) who presented with respiratory failure due to a multidrug-resistant organism (MDRO) infection, predominantly Klebsiella pneumoniae (KP), and who showed significant clinical improvement during a comprehensive treatment regimen that included an adjunctive herbal nutritional intervention. The objective of this retrospective single-case report was to describe the clinical course of this patient following a nutritional intervention with two herbal beverages: Sang Shen Pu Gong Ying (SSPGY) and Wu Zhi Mao Tao Hong Zao (WZMTHZ). The patient was admitted in critical condition and managed in three phases: initial antibiotics with occasional herbal beverages, daily herbal beverages, and a combination of herbal beverages with intermittent antibiotics. Retrospective analysis of clinical data revealed significant improvements post-intervention. Body weight increased from 26 kg to 35.5 kg at discharge and 39 kg at the 6-week follow-up. Vital signs normalized, with no detectable KP in the final hospital phase. Inflammatory markers, including C-reactive protein and white blood cell count, decreased markedly. Neurological status, as indicated by neurofilament light chain (NfL) levels, improved, and the patient showed respiratory autonomy and positional changes. Nutritional markers, total protein and creatinine, also improved. This case documents clinical improvements, including extended ventilator-free breathing periods, in an ALS patient with MDRO infection following a combined therapeutic approach. Although concurrent medical interventions were administered in real-world clinical practice, these findings suggest the potential value of this adjunctive intervention, warranting further systematic investigation. Clinical Trial Registration: identifier ITMCTR2024000322.