Okay so this is going to take a little while so bear with me here.
One change made to the whole picture was the use of 4 different gradients to give it some atmosphese. One on the bottom blocked the end of the picture from being seen and just show the photo going to black. Another on the top did much the same for the title part. The tird was on the top again and was to slightly darken out the top of Louis's head so he seemed to mesh with the picture better. The final one was on the left side and it was added like the third one, to make Louis blend better.
First I obviously reversed my hunter to place him facing to the right instead of left. This makes him able to take up more space without being cut off. I also erased part of his leg so that he was behind the post. I had to do this because there was a filter (darkening and contrast boost) that i wanted on the background but not the hunter. I also boosted contrast and altered the hue of the hunter's legs and hands to give them a bloody red look like the hunter from the game. Finally I added some blood stains to the mouth and the hoodie of the hunter to show how deadly the Zombie can be.
For the background, I simply applied a darkening and contrast boost filter as well as a slight film grain above it and the hunter to give it the grainy feel that left 4 dead has. I also simulated the writing seen on the wall in game with text turned at a slight angle and added the bloody handprint for good measure. This too was partially erased to hide parts behind the post. I also used liquify to alter his mouth out of an apparent smile to more of a scowl.
For all text excluding the Left 4 Dead Title , I made a number of text layers and set them around the picture to give the proper feel for the title (Louis and the Hunter), the flair text (Pills) and the "Credits" at the bottom
For the Top Title, I teped out Left and Dead in one layer and then drew in a blood stain based on a pic I saw online and then, on a new layer, placed the 4 so that it matches the classic Left 4 Dead look
Finally, We have Louis himself who took the most work. Placing him in the image wasn't difficult, but when I decided that I wanted him to match his in game model, I spent 3 hours using tools ranging from the line tool to the spot fix to a spray can like tool to give him a totally fake bald head and I'm extremely proud of that. I also used liquify to gently give him a more concerned look on his face and to slump his shoulder so he looks a little more beaten down by the whole experience