Invasive Bacterial Disease

Overview

Invasive bacterial diseases including group A streptococcus (Streptococcus pyogenes), Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, and Streptococcus pneumoniae isolated from normally sterile sites are reportable in Indiana residents.

Normally Sterile Sites

• Blood
• Cerebrospinal fluid (CSF)
• Pleural fluid
  • Chest fluid
  • Thoracentesis fluid
• Peritoneal fluid
  • Abdominal fluid
  • Ascites
• Pericardial fluid
• Bone
  • Bone marrow
• Joint fluid
  • Synovial fluid
  • Fluid, needle aspirate, or culture of any specific joint
    • Knee
    • Ankle
    • Elbow
    • Hip
    • Wrist
• Internal body sites
  • Specimen obtained from surgery or aspirate from one of the following
    • Lymph node
    • Brain
    • Heart
    • Liver
    • Spleen
    • Vitreous fluid
    • Kidney
    • Pancreas
    • Ovary
    • Vascular tissue

Exceptions

Group A Streptococcus if the source is

• Muscle
• Tissue or biopsy that is surgically obtained
• Any site (even non-sterile sites) in a case of toxic shock syndrome (TSS) or necrotizing fasciitis (NF)

PDF copy of this list available at this link: Normally Sterile Sites

Page last updated/reviewed: April 2026