1. Cardiovascular Syndromes
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.1.1 | Infective endocarditis |
Staphylococcus aureus Viridans Streptococci Other Staphylococci HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) Streptococcus gallolyticus subspecies gallolyticus Health care-associated IE: most commonly caused by S. aureus, Coagulase-negative Staphylococci (CoNS), and Enterococci |
Harrison's Principles of Internal Medicine Table 57-5 Pg 1023-1024 |
| B.1.2 | Myocarditis | Infective: Viral (coxsackie A, adenovirus, HIV, hepatitis C) Spirochetal (Borrelia burgdorferi—Lyme disease) Rickettsial (Q fever) Parasitic (Rare) (T. cruzi—Chagas’ disease, trypanosomiasis, toxoplasmosis) Bacterial (Rare):Diphtheria Fungal (with systemic infection) | Harrison’s Principles of Internal Medicine Table 259-4 Pg 1959 |
| B.1.3 | Pericarditis | Viral (Coxsackievirus A and B, Echovirus, Herpesviruses, Mumps, Adenovirus, Hepatitis, HIV) Pyogenic (Pneumococcus, Streptococcus spp., Staphylococcus spp., Neisseria spp., Legionella spp., Chlamydia spp.) Tuberculous Fungal (Histoplasma capsulatum, Candida spp., Blastomyces spp.) Other infections (syphilitic, protozoal, parasitic) | Harrison’s Principles of Internal Medicine Table 270-1 Pg 2019 |
| B.1.4 | Acute Rheumatic Fever | It is a sequalae of infection with Group A streptococci, certain M-serotypes (particularly types 1, 3, 5, 6, 14, 18, 19, 24, 27, and 29) | Harrison’s Principles of Internal Medicine Pg 2767 |
2. Central Nervous System Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.2.1 | Brain abscess | In immunocompetent individuals: Streptococcus spp. (anaerobic, aerobic, and viridans) Enterobacteriaceae (Proteus spp., Escherichia coli, Klebsiella spp.) Anaerobes (e.g., Bacteroides spp., Fusobacterium spp.) Staphylococci In immunocompromised hosts: Nocardia spp. Toxoplasma gondii Aspergillus spp. Candida spp. Cryptococcus neoformans In India and East Asia, mycobacterial infection (tuberculoma) remains a major cause of focal CNS mass lesions. | Harrison’s Principles of Internal Medicine Pg 1117 |
| B.2.2 | Encephalitis | Immunocompetent patients: Viral: Japanese encephalitis virus, Herpes simplex virus, Chandipura virus (Telangana, Maharashtra, Gujarat, Odisha, Bihar), Nipah virus (West Bengal, Kerala), Enteroviruses, Dengue, Influenza A (H1N1) (H3N2), Kyasanur forest disease (KFD), Rabies, Chikungunya,West Nile (Assam, Kerala), Zika virus Bacterial: Mycobacterium tuberculosis, Orientia tsutsugamushi (Scrub typhus), Leptospira spp. (Assam, Kerala), Neisseria meningitides Parasitic: Plasmodium falciparum, Naegleria fowleri Immunosuppressed patients: Viral: HIV, EBV, CMV, Parvovirus B19, Human herpes virus 6 Unvaccinated children: Viral: Measles, Mumps, Rubella (clusters), Chickenpox (clusters) Bacterial: Streptococcus pneumoniae (~1%), Haemophilus influenzae (<1%) Newer agents: Viral: SARS-CoV-2 (direct or autoimmune- mediated) | Tandale BV, Narang R, Vijay Kumar G, Jain M, Tomar SJ, Deshmukh PS. Infectious Causes of Acute Encephalitis Syndrome in India - Decadal Change and the Way Forward. Indian Pediatr. 2023 Sep 15;60(9):709-713. Epub 2023 May 30. PMID: 37260063. Available from: https://www.indianpediatrics.net/sep2023/709.pdf |
| B.2.3 | Meningitis | Bacterial: Streptococcus pneumoniae Neisseria meningitidis Group B Streptococci Listeria monocytogenes Haemophilus influenzae type b | Harrison’s Principles of Internal Medicine Pg 1100-1101 |
| B.2.4 | Healthcare- Associated Ventriculitis and CSF shunt infections | Bacterial: Staphylococci (MSSA, MRSA) Propionibacterium acnes Streptococcus pneumoniae Pseudomonas aeruginosa Haemophilus influenzae Extended spectrum β-lactamase-producing Gram-negative bacilli Acinetobacter baumannii Other Enterobacteriaceae Fungal: Candida spp. Aspergillus spp. | 2017 Infectious Diseases Society of America’s Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis Pg 52. Available from: https://academic.oup.com/cid/article/64/6/e34/2996079 |
3. Febrile Syndromes
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.3.1 | Acute undifferentia ted fever |
|
Harrison's Principles of Internal Medicine Table 187-1, Pg 1432
https://ncdc.mohfw.gov.in/wp- content/uploads/2024/05/Nation al-Guidelines-Diagnosis-Case- Management-Prevention-control- of-leptospirosis.pdf
Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC. Acute Hand Infections. Am Fam Physician. 2019 Feb 15;99(4):228-236. PMID: 30763047. |
| B.3.2 | Enteric fever |
Salmonella Typhi Salmonella Paratyphi A Salmonella Paratyphi B |
Harrison's Principles of Internal Medicine |
| B.3.3 | PUO |
Bacterial: Mycobacteriumtuberculosis (extrapulmonary TB) Occult abscesses (hepatic, pelvic, splenic - polymicrobial) Infective endocarditis (Staphylococcus aureus, Streptococcus viridans,HACEK group) Brucellosis: Brucellaspp. Typhoid fever (Salmonella Typhi/Paratyphi) Leptospirosis - Leptospirainterrogans Rickettsial infections (R.conorii,O.tsutsugamushi(Scrub typhus)) Q fever: Coxiellaburnetii Whipple's disease: Tropherymawhipplei Viral: Epstein-Barr Virus (EBV) Cytomegalovirus (CMV) HIV (Acute retroviral syndrome and AIDS-associated infections) Hepatitis B and C viruses Dengue, Chikungunya, Zika viruses COVID-19 (long-fever variants) Measles, mumps, rubella (in certain populations) Parasitic: Malaria:Plasmodiumspp.(P.vivax,P. falciparum) Visceral leishmaniasis (Kala-azar): Leishmania donovani Toxoplasmosis:Toxoplasma gondii Schistosomiasis: Schistosoma spp. Amoebic liver abscess: Entamoeba histolytica Fungal: Histoplasmacapsulatum Candidiasis (deep-seated): Candidaspp. Cryptococcusneoformans Other Zoonotic/Vector-borne Diseases: Relapsing fever - Borreliaspp. Tick-borne diseases - Anaplasmaspp., Ehrlichia spp. Rat-bite fever - (Streptobacillus moniliformis, Spirillum minus) Melioidosis - Burkholderia pseudomallei |
Harrison's Principles of Internal Medicine Chapter 20 table 20-2Pg 146 |
| B.3.4 | Sepsis Syndrome |
Gram negative bacteria: Escherichia coli Klebsiella pneumoniae Pseudomonas aeruginosa Acinetobacter spp. Gram-positive bacteria: Staphylococcus aureus Coagulase Negative Staphylococci Enterococcus spp. Fungal: Candida spp. |
Harrison's Principles of Internal Medicine 21st Edition Pg 2242 |
4. Gastro-intestinal (GI) Syndromes
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.4.1 | Infectious Oesophagitis |
Immunocompromised patients: Candida spp. Herpesvirus Cytomegalovirus (CMV) Immunocompetent (rare): Herpes simplex Virus Candida albicans |
Harrison's Principles of Internal medicine, Pg 2432 |
| B.4.2 | Acute Gastroenteritis | Bacterial: Bacillus cereus Staphylococcus aureus Clostridium perfringens Vibrio cholerae Enterotoxigenic E. coli Klebsiella pneumoniae Aeromonas species Enteropathogenic E. coli Enteroadherent E. coli Haemorrhagic E. coli Clostridium difficile Salmonella spp Campylobacter Aeromonas spp Vibrio parahaemolyticus Yersinia spp Shigella spp Enteroinvasive E. coli Parasitic: Giardia lamblia Cryptosporidiosis Entamoeba histolytica Helminths Viral: Rotavirus Norovirus | 1. Harrison’s Principles of Internal medicine, Pg 300 2. Diagnosis and Management of Complicated Intraabdominal Infection in Adults and Children: Guidelines by the Surgical Infection Society And the Infectious Diseases Society of America 3. Guideline for the Antibiotic Use in Acute Gastroenteritis. Infect Chemother. 2019 Jun;51(2):217-243. https://doi.org/10.3947/ic.2019.51.2.217 |
| B.4.3.1 | Infections of Liver, Gall Bladder and Biliary tract | Liver abscess Bacterial: Escherichia coli Klebsiella pneumoniae Enterococcus faecalis Staphylococccus aureus Streptococcus spp. Parasitic: Entamoeba histolytica Ascaris lumbricoides Fasciola hepatica Clonorchis sinensis Fasciolopsis busci Fungal: Candida spp. Aspergillus spp. | Kozielewicz DM, Sikorska K, Stalke P. Liver abscesses – from diagnosis to treatment. Clin Exp Hepatol. 2021 Dec;7(4):329–36. |
| B.4.3.2 | Infections of Liver, Gall Bladder and Biliary tract | Acute cholangitis & cholecystitis: Bacterial: Escherichia coli (25%-50%) Klebsiella species (15%-20%) Enterococcus spp Staphylococcus spp Streptococcus spp Enterobacter spp (5%-10%) Pseudomonas aeruginosa Proteus spp Anaerobic bacteria (Bacteroides fragilis and Clostridium perfringens can also cause acute cholangitis, particularly in patients with previous biliary surgery and in the elderly population) Fungal: Candida spp. Parasitic: Clonorchis sinensis Opisthorchis viverrini Opisthorchis felineus Ascaris lumbricoides | 1. Ahmed M. Acute cholangitis - an update. World J Gastrointest Pathophysiol. 2018 Feb 15;9(1):1-7. 2. Rupp C, Bode K, Weiss KH, Rudolph G, Bergemann J, Kloeters-Plachky P, Chahoud F, Stremmel W, Gotthardt DN, Sauer P. Microbiological Assessment of Bile and Corresponding Antibiotic Treatment: A Strobe-Compliant Observational Study of 1401 Endoscopic Retrograde Cholangiographies. Medicine (Baltimore). 2016 Mar;95(10):e2390. |
| B.4.4 | Appendicitis | In early stages of infection, the overgrowth is mainly aerobic organisms, but as the disease progresses, it transitions to a mix of aerobic and anaerobic bacteria. Members of family Enterobacteriaceae including Escherichia coli, Bacteroides fragilis, Fusobacterium spp, Streptococcus spp. | Bhangu, A., Søreide, K., Di Saverio, S., Assarsson, J. H., & Drake, F. T. (2015). Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. The Lancet, 386(10000), 1278–1287 |
| B.4.5 | Diverticulitis | Acute diverticulitis involves micro- or macro-perforation with translocation of commensal bacteria across the colon mucosal barrier, sometimes resulting in frank infections, including abscess formation and peritonitis. Bacterial: Bifidobacterium spp. Enterobacteriaceae family Clostridium spp. | Strate LL, Morris AM. Epidemiology, Pathophysiology, and Treatment of Diverticulitis. Gastroenterology. 2019 Apr;156(5):1282-1298 |
| B.4.6 | Peritonitis | Primary Peritonitis- Bacterial: Escherichia coli Streptococci Enterococci Pneumococci Secondary Peritonitis – Bacterial: Gram-negative bacilli, particularly E. coli Bacteroides fragilis | Harrison’s Principles of Internal medicine, Pg 1055, 1056 |
| B.4.7 | Splenic abscess | Bacterial: E. coli Streptococcus spp. Staphylococcus aureus Klebsiella spp Burkholderia pseudomallei Pseudomonas aeruginosa Bacteroides fragilis Polymicrobial infections may be seen. | 1. Sreekar H, Saraf V, Pangi AC, Sreeharsha H, Reddy R, Kamat G. A retrospective study of 75 cases of splenic abscess. Indian J Surg 2011; 73:398–402.2. Singh AK, Karmani S, Samanta J, et al. . Splenic abscess in a tertiary care centre in India: clinical characteristics and prognostic factors. ANZ J Surg 2021; 91:1819–25.3. Harrison’s Principles of Internal medicine, Pg 1055, 1056 |
5. Urinary Tract Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.5.1 | Acute Cystitis and acute pyelonephritis |
Bacterial: E.coli Klebsiellaspp Proteus spp Enterococcusspp Citrobacter spp Pseudomonas spp Staphylococcussaprophyticus (frequent isolation from younger women) |
Harrison's Principles of Internal medicine, Pg 1071 |
6. Gynaecological & Reproductive organ Infections and STDs
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.6.1 | Genital Ulcers Non-Herpetic Ulcers | Treponema pallidum (Syphilis) Chlamydia trachomatis serovars L1– L3 (Lymphogranuloma venereum) Haemophilus ducreyi (Chancroid) Klebsiella granulomatis (Donovanosis) | National Technical Guidelines on STI and RTI 2024 Pg 33 |
| B.6.2 | Anogenital Warts | Human Papilloma Virus type 6 & 11 | National Technical Guidelines on STI and RTI 2024 Pg 91 |
| B.6.3 | Septic abortion | Infections are polymicrobial Bacterial: Staphylococcus aureus Group A & B streptococcus Escherichia coli Clostridium perfringens Peptostreptococcus spp. | Udoh A, Effa EE, Oduwole O, Okusanya BO, Okafo O. Antibiotics for treating septic abortion. Cochrane Database Syst Rev. 2016 Jul 1;7(7):CD011528. doi: 10.1002/14651858.CD011528.pub2. PMID: 27364644; PMCID: PMC6458041. |
| B.6.4 | Vaginitis & Cervicitis |
Vaginitis: Parasitic Trichomonas vaginalis (Trichomoniasis) Fungal: Candida albicans (Candidiasis) Bacterial: Gardnerella vaginalis Mobiluncus spp. Mycoplasma hominis Ureaplasma spp. Other fastidious and uncultivated anaerobes e.g., Bacteroides spp. (Bacterial vaginosis) Cervicitis: Bacterial: Neisseria gonorrhoeae Chlamydia trachomatis M. genitalium Parasitic: Trichomonas vaginalis Viral: Genital herpes (especially primary HSV-2 infection) |
National Technical Guidelines on STI and RTI 2024 Pg 39 |
| B.6.5 | Epididymo- Orchitis |
Bacterial: N. gonorrhoeae C. trachomatis M. genitalium Enteric organisms (E. coli) |
National Technical Guidelines on STI and RTI 2024 Pg 73 |
| B.6.6 | Pelvic Inflammatory Disease |
Bacterial: Neisseria gonorrhoeae Chlamydia trachomatis Mobiluncus spp. Mycoplasma hominis Gardnerella spp. Anaerobic bacteria (Bacteroides sp.) Gram-positive cocci |
National Technical Guidelines on STI and RTI 2024 Pg 47 |
| B.6.7 | Prostatitis |
Bacterial: E.coli Pseudomonas aeruginosa Enterococcus spp. Proteus spp. Klebsiella spp. Enterobacter spp. Neisseria Gonorrhea Chlamydia trachomatis Fungal: Candida spp. |
Khan, F. U., Ihsan, A. U., Khan, H. U., Jana, R., Wazir, J., Khongorzul, P., Zhou, X. (2017). Comprehensive overview of prostatitis. Biomedicine & Pharmacotherapy, 94, 1064-1076. |
| B.6.8 | Puerperal sepsis |
Bacterial: Aerobes: Gram-positive cocci: Group A, B, and D streptococci Enterococcus spp. Staphylococcus aureus Staphylococcus epidermidis Gram-negative bacteria: Escherichia coli Klebsiella spp. Proteus spp. Gram-variable: Gardnerella vaginalis Others: Mycoplasma spp. Chlamydia spp. Neisseria gonorrhoeae Anaerobes: Peptostreptococcus spp. Peptococcus spp. Clostridium spp. Bacteroides spp. Fusobacterium spp. Mobiluncus spp. |
Williams OBSTETRICS 2 4 T H E D I T I O N. Pg 683 |
| B.6.9 | Urethral discharge syndrome | Bacterial: Neisseria gonorrhoeae Chlamydia trachomatis Mycoplasma genitalium Parasitic: Trichomonas vaginalis | National Technical Guidelines on STI and RTI 2024 Pg 33 |
| B.6.10 | Chorio-amnionitis | Polymicrobial infections are detected in 70% infections with clinical chorioamnionitis and intraamniotic infections: Bacterial: Ureaplasma spp. Gardnerella vaginalis Mycoplasma hominis Staphylococcus aureus Group B Streptococcus E. coli Pseudomonas spp. Enterococcus spp. Fusobacterium spp. Fungal: Candida spp. | Jung, Eunjung et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. American Journal of Obstetrics & Gynecology, Volume 230, Issue 3, S807 - S840 |
7. Ear, Nose and Throat Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.7.1 | Rhinitis/ Common cold | Viral: - The most common viral causes of nonspecific URIs are Rhinoviruses (over 100 serotypes) Coronaviruses Parainfluenza virus Respiratory syncytial virus Influenza virus Adenovirus (57 serotypes) Metapneumovirus Bocavirus | Harrison’s Principles of Internal Medicine Pg 248 |
| B.7.2 | Laryngitis/Layn gopharyngitis/ URTI | Viral: Rhinovirus Influenza Parainfluenza RSV Human metapneumovirus Enterovirus Adenovirus Ebstein Barr virus Bacterial: Streptococcus pyogenes Pneumococcus Moraxella spp. H. influenzae S. aureus Mycoplasma spp. | Harrison’s Principles of Internal Medicine Pg 253 (Table 35-3), 255 |
| B.7.3 | Sinusitis | Viral: Rhinovirus Adenovirus Influenza and Parainfluenza virus Bacterial: S. pneumoniae H. influenzae M. catarrhalis Staphylococcus aureusPorphyromonas spp. Enterobacteriaceae Fungal: Mucorales fungi Aspergillus spp. | Harrison’s Principles of Internal Medicine Pg 251 – 252 Aring AM, Chan MM. Current Concepts in Adult Acute Rhinosinusitis. Am Fam Physician. 2016 Jul 15;94(2):97-105. PMID: 27419326. |
| B.7.4 | Acute Otitis Media | Viral: Respiratory syncytial virus Rhinoviruses Enteroviruses Coronaviruses Influenza virus Adenoviruses Human metapneumovirus Bacterial: Streptococcus pneumoniae Nontypeable Haemophilus influenzae Moraxella catarrhalis | Harrison’s Principles of Internal Medicine Pg 249 |
| B.7.5 | Otitis externa | Bacterial: Pseudomonas aeruginosa Staphylococcus aureus Fungal: Aspergillus spp. Candida spp. | Harrison’s Principles of Internal Medicine Pg 249 |
| B.7.6 | HEAD AND NECK ABSCESSES (peritonsillar/p arapharyngeal and retropharyngea l abscess) | Bacterial: Virulent invasive pathogens Streptococcus pyogenes S. aureus H. Influenzae Facultative anaerobes Viridans group streptococci H. parainfluenza Moraxella catarrhalis Eikenella corodans Cutibacterium acnes Mycobacterium species other than tuberculosis. Obligate anaerobes: F. necrophorum Prevotella spp. Bacteroides fragilis Porphyromonas spp. | Orzell S, Suryadevara A. Pharyngitis and Pharyngeal Space Infections: fever, sore throat, difficulty swallowing. Introduction to Clinical Infectious Diseases. 2018 Oct 15:53–66. |
8. Oral cavity, Head and Neck Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.8.1 | Oropharyngeal Candidiasis | Candida albicans (most common) C. glabrata C. guillermondii C. krusei C. lusitaniae C. parapsilosis | Hellstein JW, Marek CL. Candidiasis: Red and White Manifestations in the Oral Cavity. Head Neck Pathol. 2019 Mar;13(1):25-32. |
9. Skin and Soft Tissue Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.9.1 | Acute paronychia | Bacterial: Staphylococcus aureus Streptococcus pyogenes Enterococcus spp. Klebsiella pneumoniae Fusobacterium species Peptostreptococcus spp. Porphyromonas spp. Prevotella spp. Pseudomonas aeruginosa Fungal: Candida albicans | Relhan, Vineet; Bansal, Anuva. Acute and chronic paronychia revisited: A narrative review. Journal of Cutaneous and Aesthetic Surgery 15(1):p 1-16, Jan–Mar 2022. | DOI: 10.4103/JCAS.JCAS_30_21 |
| B.9.2 | Impetigo | Bacterial: Staphylococcus aureus Streptococcus pyogenes | Harrison’s Principles of Internal Medicine Pg4466 |
| B.9.3 | Cellulitis | Bacterial: Staphylococcus aureus Staphylococcus pyogenes Group A Streptococci Pseudomonas spp. | Harrison’s Principles of Internal Medicine Pg 4468 |
| B.9.4 | Necrotizing fasciitis | Type 1: Polymicrobial (Anaerobic streptococci and aerobic Gram- positive and Gram-negative bacteria Type 2: Beta hemolytic streptococcus A, Staphylococcus aureus Type 3: Vibrio spp., Clostridium spp, Gram-negative bacteria Type 4: Candida spp. and zygomycetes | Guliyeva G, Huayllani MT, Sharma NT, Janis JE. Practical Review of Necrotizing Fasciitis: Principles and Evidence-based Management. Plast Reconstr Surg Glob Open. 2024 Jan 19;12(1):e5533. doi: 10.1097/GOX.0000000000005533. PMID: 38250213; PMCID: PMC10798703 |
| B.9.5 | Primary pyomyositis | Bacterial: Staphylococcus aureus Group A Streptococcus Streptococcus pneumoniae Gram – negative enteric bacteria | Dennis L. Stevens, Alan L. Bisno, Henry F. Chambers, E. Patchen Dellinger, Ellie J. C. Goldstein, Sherwood L. Gorbach, Jan V. Hirschmann, Sheldon L. Kaplan, Jose G. Montoya, James C. Wade, Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America, Clinical Infectious Diseases, Volume 59, Issue 2, 15 July 2014, Pages e10– e52, https://doi.org/10.1093/cid/ciu296 |
| B.9.6 | Folliculitis | Bacterial: Staphylococcus aureus Klebsiella spp. Enterobacter spp. Proteus spp. Pseudomonas aeruginosa Fungal: Malassezia furfur | Lin HS, Lin PT, Tsai YS, Wang SH, Chi CC. Interventions for bacterial folliculitis and boils (furuncles and carbuncles). Cochrane Database Syst Rev. 2021 Feb 26;2(2):CD013099. doi: 10.1002/14651858.CD013099.pub2. PMID: 33634465; PMCID: PMC8130991. |
| B.9.7 | Diabetic foot infections | Bacterial: Gram positive: Staphylococcus aureus Enterococcus fecalis Streptococcus pneumoniae Streptococcus agaliticae Staphylococcus epidermidis Gram negative aerobes: E.coli Pseudomonas aeruginosa Klebsiella spp Acinetobacter baumanii Enterobacter cloacae Gram negative anaerobes: Bacteroides fragilis Fusobacterium spp. | Jneid, J.P. Lavigne, B. La Scola, N. Cassir,The diabetic foot microbiota: A review,Human Microbiome Journal,Volumes 5–6,2017,Pages 1-6, ISSN 2452-2317 |
10. Musculoskeletal Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.10.1 | Acute osteomyelitis | Bacterial: Staphylococcus aureus Streptococci Escherichia coli Pseudomonas aeruginosa | Harrison’s Principles of Internal Medicine Pg 3936 |
| B.10.2 | Chronic osteomyelitis | Bacterial: Staphylococcus aureus (most common) Mycobacterium tuberculosis Gram negative bacteria Coagulase negative staphylococci Anaerobes Streptococci Enterococci Polymicrobial infections are also seen. | Ahmed Barakat, William HK. Schilling, Sunil Sharma, Enis Guryel, Richard Freeman, Chronic osteomyelitis: a review on current concepts and trends in treatment,Orthopaedics and Trauma,Volume 33, Issue 3,2019,Pages 181-187,ISSN 1877-1327 |
| B.10.3 | Gas gangrene | Clostridium perfringens Clostridium septicum Clostridium novyi C.tertium Clostridium sordelli | Harrison’s Principles of Internal Medicine Pg 1222 |
| B.10.4 | Septic arthritis | Infants: Group B streptococci Gram-negative enteric bacilli S. aureus Children < 5 years: S. aureus Streptococcus pyogenes Young adults and adolescents: N. gonorrhoeae Adults: S. aureus Gram-negative bacilli Pneumococci β-hemolytic streptococci— particularly groups A and B but also groups C, G, and F | Harrison’s Principles of Internal Medicine Pg 1041 |
| B.10.5 | Skin and soft tissue injuries | Wound infections are often polymicrobial. Bacterial: Aerobic bacteria Staphylococcus aureus Escherichia coli Pseudomonas aeruginosa Enterobacter cloacae Klebsiella spp. Streptococcus spp. Enterococcus spp. Proteus spp. Anaerobic bacteria Peptostreptococcus spp. Prevotella spp. Porphyromonas spp. Bacteroides spp. | Maillard JY, Kampf G, Cooper R. Antimicrobial stewardship of antiseptics that are pertinent to wounds: the need for a united approach. JAC Antimicrob Resist. 2021 Mar 25;3(1):dlab027. |
| B.10.6 | Orthopedic implant associated infections | Bacterial: Staphylococcus aureus Staphylococcus epidermidis Propionibacterium acnes Enterococcus faecalis | Ihtisham Ul Haq, Taj Ali Khan, Katarzyna Krukiewicz, Etiology, pathology, and host- impaired immunity in medical implant- associated infections, Journal of Infection and Public Health, Volume 17, Issue 2, 2024, Pages 189-203, ISSN 1876-0341, https://doi.org/10.1016/j.jiph.2023.11.024 |
| B.10.7 | Surgical site infections | Bacterial: Staphylococcus aureus Coagulase negative Staphylococcus Enterococcus faecium and E. fecalis Escherichia coli Pseudomonas aeruginosa Enterobacter spp. Klebsiella spp. | Bucataru A, Balasoiu M, Ghenea AE, Zlatian OM, Vulcanescu DD, Horhat FG, Bagiu IC, Sorop VB, Sorop MI, Oprisoni A, Boeriu E, Mogoanta SS. Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors. Clin Pract. 2023 Dec 28;14(1):52-68. |
11. Ocular Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.11.1.1 | Conjunctivitis | Viral: Adenoviruses Herpes simplex virus Varicella zoster Enterovirus Bacterial: Staphylococcus spp. H. influenzae Streptococcus spp. Moraxella catarrhalis Gram-negative intestinal bacteria Ophthalmia neonatorum Chlamydia trachomatis | Azari AA, Arabi A. Conjunctivitis: A Systematic Review. J Ophthalmic Vis Res. 2020 Aug 6;15(3):372-395. doi: 10.18502/jovr.v15i3.7456. |
| B.11.1.2 | Keratitis | Bacterial: Staphylococcus spp. Staphylococcus aureus Pseudomonas aeruginosa Viral: HSV type 1 CMV VZV EBV Adenovirus Fungal: Candida spp. Fusarium spp. Aspergillus spp. Parasitic: Acanthamoeba spp. | 1. Cabrera-Aguas M, Khoo P, Watson SL. Infectious keratitis: A review. Clin Exp Ophthalmol. 2022 Jul;50(5):543-562. doi: 10.1111/ceo.14113. 2. Koganti R, Yadavalli T, Naqvi RA, Shukla D, Naqvi AR. Pathobiology and treatment of viral keratitis. Exp Eye Res. 2021 Apr;205:108483. doi: 10.1016/j.exer.2021. |
| B.11.2.1 | Acute Endophthalmitis | Bacterial: Coagulase Negative Staphylococci Staphylococcus aureus Beta-hemolytic Streptococci S.pneumoniae Alpha – haemolytic streptococci including S.mitis and S.salivarius Pseudomonas Aeruginosa Fungal: Candida spp. Aspergillus spp. Fusarium spp. | ESCRS Guidelines for Prevention and Treatment of Endophthalmitis Following Cataract Surgery: Data, Dilemmas and Conclusions 2013 |
| B.11.2.2 | Chronic Endophthalmitis | Bacterial: Propionibacterium acnes Corynebacterium spp. S.epidermidis | ESCRS Guidelines for Prevention and Treatment of Endophthalmitis Following Cataract Surgery: Data, Dilemmas and Conclusions 2013 |
| B.11.2.3 | Endogenous Endophthalmitis | Bacterial: Staphylococcus aureus Streptococcus spp. Gram Negative bacilli (Eg., Klebsiella spp.) Fungal: Candida spp. Aspergillus spp. Fusarium spp. | Endophthalmitis Durand, M.L.Clinical Microbiology and Infection, Volume 19, Issue 3, 227 – 234. |
| B.11.3.1 | Orbital cellulitis | Bacterial: Streptococcal spp. Staphylococcus aureus H. influenzae Propionibacterium spp. Bacillus spp. Bacteroides spp. Peptostreptococcus spp. Fusiobacterium spp. | Yadalla D, Jayagayathri R, Padmanaban K, Ramasamy R, Rammohan R, Nisar SP, Rangarajan V, Menon V. Bacterial orbital cellulitis - A review. Indian J Ophthalmol. 2023 Jul;71(7):2687-2693. doi: 10.4103/IJO.IJO_3283_22. |
| B.11.3.2 | Preseptal cellulitis | Bacterial: Staphylococcus spp. (majority of infections) Streptococcus spp. (majority of infections) Haemophilus influenzae M. catarrhalis Peptostreptococcus spp. Bacteroides spp. Immunocompromised hosts Fungal: Mucormycosis and Aspergillosis | 1. A.A. Gordon and P.O. Phelps, Management of preseptal and orbital cellulitis for the primary care physician, Disease-a-Month, https://doi.org/10.1016/j.disamonth.2020.1 01044 2. KANSKI'S Clinical Ophthalmology A Systematic Approach Tenth Edition.Pg 124-125 |
| B.11.4 | Infectious retinitis | Viral: Cytomegalovirus VZV HSV Type 1 & 2 Fungal: Candida albicans Aspergillus spp. Parasitic: Toxoplasma gondii Toxocara canis Others: Treponema pallidum Bartonella henselae (uncommon) | Yachna Ahuja, Steven M. Couch, Raymund R. Razonable, Sophie J. Bakri. Infectious retinitis: a review Available from: https://www.retinalphysician.com/issues/2008 /novdec/infectious-retinitis-a-review/ |
12. Respiratory Tract Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.12.1 | Acute bronchitis | Viral: Rhinovirus Enterovirus Influenza A and B Parainfluenza Coronavirus Human metapneumovirus, Respiratory Syncytial Virus Adenovirus Bacterial: Atypical bacteria Mycoplasma pneumoniae Chlamydia pneumoniae Bordetella pertussis | Kinkade S, Long NA. Acute Bronchitis. Am Fam Physician. 2016 Oct 1;94(7):560-565. PMID: 27929206. |
| B.12.2 | Bronchiolitis | In adults, symptomatic acute infectious bronchiolitis (without pneumonia) is uncommon, but can be caused by pathogens, such as: Viral: Influenza virus Respiratory syncytial virus Rhinovirus Adenovirus Parainfluenza virus Human Metapneumovirus Bacterial: M. pneumoniae Haemophilus influenzae Streptococcus pneumoniae | Aparna C. Swaminathan, John M. Carney, Tina D. Tailor, and Scott M. Palmer. Overview and Challenges of Bronchiolar Disorders.Ann Am Thorac Soc Vol 17, No 3, pp 253–263, Mar 2020 DOI: https://doi.org/10.1513/AnnalsATS.201907-569CME |
| B.12.3 | COPD | Viral: Human rhinovirus subtypes A and C RSV Coronavirus Influenza and Parainfluenza virus Bacterial: Haemophilus influenzae Streptococcus pneumoniae Moraxella catarrhalis Pseudomonas aeruginosa Chlamydia pneumoniae | 1. Harrison’s Principles of Internal Medicine Pg 2189 2. Papadopoulos NG, Christodoulou I, Rohde G, Agache I, Almqvist C, Bruno A, et al. Viruses and bacteria in acute asthma exacerbations – A GA2LEN-DARE systematic review. Allergy 2011; 66: 458– 468. 3. WHO AWARE guidelines Pg 165 |
| B.12.4 | Infective Exacerbation of Bronchiectasis | Most common: Bacterial: Haemophilus influenzae Pseudomonas aeruginosa | Harrison’s Principles of Internal Medicine Pg 2175 |
| B.12.5 | Community acquired pneumonia | Outpatients: Bacterial: Streptococcus pneumoniae Mycoplasma pneumoniae Haemophilus influenzae C. pneumoniae Viral: Respiratory viruses Non-ICU hospitalized patients: Bacterial: S. pneumoniae M. pneumoniae Chlamydia pneumoniae H. influenzae Legionella spp. Viral: Respiratory viruses ICU patients: Bacterial: S. pneumoniae Staphylococcus aureus Legionella spp. Gram-negative bacilli H. influenzae Viral: Respiratory viruses | Harrison’s Principles of Internal Medicine Table 126-1. Pg 1010 |
| B.12.6 | Lung abscess | Primary lung abscess: Bacterial: Bacteroides spp. Prevotella spp. Peptostreptococcus spp. Streptococcus milleri Microaerophilic Streptococci Secondary lung abscess: Bacterial: Staphylococcus aureus Enterobacterales Pseudomonas aeruginosa Streptococcus pyogenes Hemophilus influenzae type b Nocardia spp. Actinomyces Anaerobic bacteria (Fusobacterium spp., or Streptococci) Legionella spp. Fungal: Mucorales Aspergillus spp. Pneumocyctis jirovecii Cryptococcus spp. | Harrison’s Principles of Internal Medicine Table 127-1. Pg 1020 |
| B.12.7 | Empyema | Bacterial: Staphylococcus aureus Streptococcus pyogenes Streptococcus pneumonie Viridans streptococci group Pseudomonas spp. Klebsiella spp. Enterobacteriaceae Acinetobacter spp. Infections may be polymicrobial in nature with involvement of both aerobic and anaerobic in nature. | Foley, Sean P. F., and John Scott Parrish. 2023. "Pleural Space Infections" Life 13, no. 2: 376, https://doi.org/10.3390/life13020376 |
13. Toxin-mediated Syndromes
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.13.1 | Botulism | Anaerobic bacterium Clostridium botulinum. Other Clostridium species: Clostridium butyricum Clostridium baratii | Harrison’s Principles of Internal Medicine Pg 1215 https://www.cdc.gov/botulism/treatment/index.html |
| B.13.2 | Diphtheria | Toxigenic strains of Corynebacterium diphtheriae. Other Corynaebacterium species: Corynebacterium ulcerans Corynebacterium pseudotuberculosis | Harrison’s Principles of Internal Medicine Pg 1203 |
| B.13.3 | Tetanus | Most common: Clostridium tetani May be complicated by: Staphylococcus epidermidis Staphylococcus aureus Propionibacterium acnes Pseudomonas aeruginosa Acinetobacter baumanii | Harrison’s Principles of Internal Medicine Pg 1211 |
| B.13.4 | Toxic shock syndrome | Staphylococcus aureus Toxic shock syndrome toxin 1 enterotoxins B Group A Streptococcus pyogenes Streptococcal pyrogenic exotoxins (SpE)A,B and C Streptococcal superantigen A | Harrison’s Principles of Internal Medicine Pg 1183Atchade E, De Tymowski C, Grall N, Tanaka S, Montravers P. Toxic Shock Syndrome: A Literature Review. Antibiotics (Basel). 2024 Jan 18;13(1):96. doi: 10.3390/antibiotics13010096. PMID: 38247655; PMCID: PMC10812596. |
14. Bite wound infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.14.1 | Human and animal bites wound infections | Dog bite Staphylococcus aureus Pasteurella multocida Anaerobes Capnocytophaga Canimorsus Cat Bite P. multocida S. aureus Anaerobes Human & monkey bites Viridans streptococci S. aureus Haemophilus influenzae Anaerobes Eikenella corrodens Rodent bites Streptobacillus moniliformis Leptospira spp. P. multocida Aquatic animal bites Aeromonas hydrophila marine Vibrio spp. (Vibrio vulnificus) | Table 141-1 Harrison’s Principles of Internal Medicine Pg 1127 |
15. Burn wound infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.15.1 | Burn wound infections | Bacterial: Staphylococcus aureus Streptococcus pyogenes Pseudomonas aeruginosa Coagulase negative Staphylococcus Enterococcus spp. E.coli Fungal: Candida spp. | Church DElsayed SReid O, Winston B, Lindsa y R. 2006. Burn Wound Infections. Clin Microbiol Rev 19: https://doi.org/10.1128/cmr.19.2.403-434.2006 |
16. Dental Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.16.1 | Odontogenic infections | Odontogenic infections are polymicrobial, consisting of various facultative anaerobes, such as: S. mitis S. sanguinis S. salivarius S. anginosus S. viridans group AND Strict anaerobes: Anaerobic cocci Prevotella spp. Fusobacterium spp. | Tahmasebi, E.; Keshvad, A.; Alam, M.; Abbasi, K.; Rahimi, S.; Nouri, F.; Yazdanian, M.; Tebyaniyan, H.; Heboyan, A.; Fernandes, G.V.O. Current Infections of the Orofacial Region: Treatment, Diagnosis, and Epidemiology. Life 2023, 13, 269. Available from: https://doi.org/10.3390/life13020269 |
17. Infections in Immuno-compromised hosts
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.17.1 | Febrile neutropenia syndrome | Bacterial: Enterobacteriaceae Pseudomonas spp. Staphylococcus spp. Streptococcus spp. Fungal: Candida spp. Molds Viral: Respiratory viruses HSV VZV | Villafuerte-Gutierrez P, Villalon L, Losa JE, Henriquez-Camacho C. Treatment of febrile neutropenia and prophylaxis in hematologic malignancies: a critical review and update. Adv Hematol. 2014;2014:986938. |
| B.17.2 | Title: Infections in Solid Organ Transplant patients | ||
| Time interval | <4 weeks of transplant | 1-6 months after SOT | >6 months after SO |
| Bacterial: Methicillin Resistant Staphylococcus aureus (MRSA) Vancomycin resistant Enterococcus (VRE) Pseudomonas spp. Fungal: Candida spp. (non albicans) Aspergillus spp. Viral: Herpes Simplex Virus LMCV | With PCP and Antiviral prophylaxis(CMV and HBV): Viral: Bk Polyoma virus nephropathy Hepatitis C Virus Adenovirus Influenza Fungal: Cryptococcus neoformans Bacterial: M.tuberculosis C.difficile colitis Without prophylaxis, following agents in addition to above: Viral: Herpesviruses(HSV, VZV, CMV,EBV) Hepatitis B Virus Bacterial: Listeria spp. Nocardia spp. Parasitic: Toxoplasma spp. Leishmania spp. Strongyloides spp. T.cruzi | Fungal: Aspergillus spp. Atypical moulds Mucor spp. Bacterial: Nocardia spp. Rhodococcus spp. Viral: CMV Colitis/Retinitis HBV/HCV HSV Encephalitis JC Polyoma Virus | |
| B.17.3 | Title | Etiology | Reference |
| Infections in Asplenia | Bacterial: Streptococcus pneumoniae Neisseria meningitidis Haemophilus influenzae type b Pseudomonas aeruginosa Capnocytophaga canimorsus Bartonella spp. Parasitic: Babesia spp. | Lee GM. Preventing infections in children and adults with asplenia. Hematology Am Soc Hematol Educ Program. 2020 Dec 4;2020(1):328-335. doi: 10.1182/hematology.2020000117 | |
| B.17.4 | Invasive Fungal Infections in Immuno-Compromised | Aspergillus spp. Candida spp. Mucormycosis: Apophysomyces spp. Basidiobolus spp. Conidiobolus spp. Cunninghamella spp. Mucor spp. Lichtheimia (Absidia) spp. Rhizomucor spp. Rhizopus spp. Saksenaea spp. Syncephalestrum spp. | https://www.who.int/publications/i/item/9789240060241 |
18. Healthcare Associated Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.18.1 | Fever in ICU | Pathogens isolated from blood: Fungal: Candida albicans Candida tropicalis Pichia kudriavzevii Nakaseomyces glabrataa Candida parapsilosis Bacterial: Enterococcus faecium Staphylococcus aureus Klebsiella pneumoniae Pseudomonas aeruginosa Escherichia coli Pathogens isolated from urine: Fever in ICU patients can be due to an underlying UTI. Presence of sign and symptoms of UTI and pyuria in urine analysis should be followed by a urine culture. Pathogens isolated from Respiratory tract: Viral: Influenza virus Respiratory syncytial virus Adenovirus Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Human metapneumovirus Seasonal coronaviruses Rhinovirus Parainfluenza virus Herpes simplex virus Cytomegalovirus Varicella-zoster virus Middle East respiratory syndrome coronavirus Sin Nombre virus Measles virus | O’Grady et al. Society of Critical Care Medicine and the Infectious Diseases Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU. Critical Care Medicine 51(11):p 1570-1586, November 2023. | DOI: 10.1097/CCM.0000000000006022 |
| B.18.2 | Invasive Candidiasis | Candida albicans C. glabrata C. parapsilosis C. tropicalis C. krusei * Incidence of Candida auris is largely associated with infection control practices of hospital. | https://www.cdc.gov/candidiasis/hcp/clinical-overview/index.html |
| B.18.3 | Ventilator Associated Pneumonia | Bacterial: Klebsiella spp. Acinetobacter spp. Pseudomonas spp. E. coli and other Enterobacteriaceae Staphylococcus aureus | Mathur P, Malpiedi P, Walia K, et al. Health- care-associated bloodstream and urinary tract infections in a network of hospitals in India: a multicentre, hospital-based, prospective surveillance study.Lancet Glob Health, 10 (2022), pp. e1317-e1325 DOI: 10.1016/S2214-109X(22)00274-1 |
| B.18.4 | CLABSI | Bacterial: Klebsiella pneumoniae Acinetobacter spp. Enterobacter spp. Citrobacter spp. Proteus spp. Serratia spp. Burkholderia cepacia complex Stenotrophomonas maltophilia Staphylococcus spp. Enterococcus spp. Fungal: Candida spp. (unspeciated) C. albicans C. tropicalis C. parapsilosis C. auris C. haemulonii C. krusei C. glabrata | Mathur et al; Indian Healthcare Associated Infection Surveillance Network collaborators. Health-care-associated bloodstream and urinary tract infections in a network of hospitals in India: a multicentre, hospital-based, prospective surveillance study. Lancet Glob Health. 2022 Sep;10(9):e1317-e1325. doi: 10.1016/S2214-109X(22)00274-1. PMID: 35961355 |
| B.18.5 | CAUTI | Bacterial: Klebsiella pneumoniae Acinetobacter spp. Enterobacter spp. Citrobacter spp. Proteus spp. Serratia spp. Burkholderia cepacia complex Stenotrophomonas maltophilia Staphylococcus spp. Enterococcus spp. | Mathur et al ; Indian Healthcare Associated Infection Surveillance Network collaborators. Health-care-associated bloodstream and urinary tract infections in a network of hospitals in India: a multicentre, hospital-based, prospective surveillance study. Lancet Glob Health. 2022 Sep;10(9):e1317-e1325. doi: 10.1016/S2214-109X(22)00274-1. PMID: 35961355 |
| B.18.6 | Hospital acquired intra-abdominal infections | In all HA-IAIs, causative pathogens are less predictable; thus, peri- operative cultures are routinely indicated | Sartelli, M., Catena, F., Abu-Zidan, F.M. et al. Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference. World J Emerg Surg 12, 22 (2017). https://doi.org/10.1186/s13017-017-0132-7 |
19. Neonatal Infections
| Annexure No. | Title | Etiology | Reference |
|---|---|---|---|
| B.19.1 | Meningitis | Bacterial: Escherichia coli Klebsiella pneumoniae Streptococcus agalactiae Listeria monocytogenes | Indian Academy of Pediatrics (IAP). STANDARD TREATMENT GUIDELINES 2022 Pg 4 |
| B.19.2 | Conjunctivitis | Bacterial: Chlamydia trachomatis Neisseria gonorrhoeae Coagulase-negative Staphylococcus Alpha-hemolytic Streptococcus Haemophilus influenzae Streptococcus pneumoniae Staphylococcus aureus Pseudomonas spp. Escherichia coli Viral: Herpes simplex Adenovirus Enterovirus | Indian Academy of Pediatrics (IAP). STANDARD TREATMENT GUIDELINES 2022 Chapter 68 Pg 3-4 |
| B.19.3 | Superficial infections - Omphalitis | Bacterial: Staphylococcus aureus Streptococcus pyogenes Streptococcus agalactiae E.coli Klebsiella spp. Enterococcus spp. Enterobacter spp. | Kaplan RL, Cruz AT, Freedman SB, Smith K, Freeman J, Lane RD, Michelson KA, Marble RD, Middelberg LK, Bergmann KR, McAneney C, Noorbakhsh KA, Pruitt C, Shah N, Badaki-Makun O, Schnadower D, Thompson AD, Blackstone MM, Abramo TJ, Srivastava G, Avva U, Samuels-Kalow M, Morientes O, Kannikeswaran N, Chaudhari PP, Strutt J, Vance C, Haines E, Khanna K, Gerard J, Bajaj L. Omphalitis and Concurrent Serious Bacterial Infection. Pediatrics. 2022 May 1;149(5):e2021054189. doi: 10.1542/peds.2021-054189. PMID: 35441224. |
| B.19.4 | Cutaneous candidiasis | Candida albicans and other Candida spp. | 1. Nelson Textbook of Pediatrics. Pg 3219 2. Harrson’s Principles of Internal Medicine Table 57-5 Pg 380 |
| B.19.5 | Viral Infections | Adenovirus CMV Enteroviruses Parechoviruses Hepatitis B virus HSV HIV Parvovirus Rubella virus VZV | 1. Nelson Textbook of Pediatrics. Pg 912. 2. Santos RP, Tristram D. A practical guide to the diagnosis, treatment, and prevention of neonatal infections. Pediatr Clin North Am. 2015 Apr;62(2):491-508. doi: 10.1016/j.pcl.2014 |