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Duke criteria for diagnosis of infectious endocarditis

Diagnostic criteria: Major criteria: 1) echocardiographic findings, i.e. mass or valvular dehiscence 2) blood cultures positive (x 2), bacteremia with typical micro-organisms - a single positive blood culture for Coxiella burnetti - antibody titer > 1:800 [1] 3) new regurgitant murmur (valvular regurgitation) Minor criteria: 1) predisposing cardiac conditions 2) history of injection drug use 3) fever of > 38 degrees C 4) vascular phenomena, i.e. signs of embolization 5) various immunological phenomena a) glomerulonephritis b) positive rheumatoid factor 6) miscellaneous echocardiographic & culture results Diagnosis is made by: 1) 2 major criteria 2) 1 major & 3 minor criteria 3) 5 minor criteria 4) pathologic criteria - culture from or histologic examination of a valvular vegetation, a vegetation that has embolized, or an intracardiac abscess

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References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2006, 2012, 2015. 2018.
  2. Li JS, Sexton DJ, Mick N, Nettles R et al Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000 Apr;30(4):633-8. Epub 2000 Apr 3. PMID: 10770721