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Life sciences · Journal article
Journal of the Indian Medical Association · October 14, 2026
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IntroductIonThe global rise of antimicrobial resistance (AMR) has necessitated a reevaluation of established broad-spectrum antibiotics, particularly in regions with high infectious disease burdens (lower respiratory infections, diarrheal diseases, malaria, and tuberculosis), such as India.Global estimates for 2019 indicate that bacterial AMR directly caused 1.27 million deaths and contributed to 4.95 million deaths overall.1,2 Febrile illness remains one of the most common reasons for clinical consultation in Indian healthcare settings, often presenting a diagnostic challenge due to the overlapping clinical features of bacterial, viral, and protozoal infections.3 Acute undifferentiated febrile illness (AUFI) represents a substantial public health burden in India, particularly in rural and resource-limited settings where diagnostic clarity is often lacking.In the present study, AUFI accounted for a major proportion of febrile presentations, with scrub typhus emerging as the leading bacterial cause (24.6%), followed by leptospirosis (12.4%).Among viral etiologies, dengue contributed to 23% of AUFI cases.The high prevalence of these infections, combined with their overlapping clinical features, underscores the ongoing challenge of timely diagnosis and effective management, highlighting the need for strengthened surveillance and improved diagnostic