Background: Patients with cirrhosis are at high risk for the development of infections, acute pharyngitis is probably the most common infection presented to the everyday clinic.
Objectives: To evaluate the role of CRP and ESR, in differentiation between bacterial and viral pharyngitis in patients with liver cirrhosis.
Patients and methods: This study conducted on 80 participants. Group A:  (cirrhotic patients) involve forty patients, twenty of them presented to the clinic with acute pharyngitis and the other twenty have no signs or symptoms suggestive acute pharyngitis. Group B: (immune-competent [non cirrhotic] patients) includes forty patients. Half of them have acute pharyngitis and the other half is clinically free. Acute viral and bacterial pharyngitis was differentiated clinically. ESR, CRP and throat culture were done for all participants
Results: The mean ESR value in viral and bacterial pharyngitis-infected hepatic patients was 50.55 ± 36.89 and 38.35 ± 28.69 respectively (p=0.242). The mean CRP value in viral and bacterial pharyngitis-infected hepatic patients was 47.38 ± 9.58, and 53.91 ± 36.37 respectively (p=0.684).  The mean ESR level in the bacterial and viral non-hepatic infected patients were 32.35 ± 2.16 and 19.25 ± 10.72 respectively with significant p-value (P=0.0001). The mean CRP value in viral and bacterial non-hepatic infected patients were 3.53 ± 3.01 and 20.35 ± 18.81 respectively with significant p-value (P=0.0001).
Conclusion:  In immunocompromised patient complaining of sore throat must undergo throat culture to identify the organism and apply the most suitable treatment to avoid antibiotic abuse, misuse and bacterial resistance.