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Table 1: Modified Duke Infective Endocarditis Criteria.7 |
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Mayor criteria |
Minor criteria |
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Blood culture positive for IE A. Typical microorganisms consistent with IE from 2 separate blood cultures: • Viridans streptococci, Streptococcus bovis, HACEK group, Staphylococcus aureus; or • Community-acquired enterococci, in the absence of a primary focus; or B. Microorganisms consistent with IE from persistently positive blood cultures, defined as follows: • At least 2 positive cultures of blood samples drawn 12 h apart; or • All of 3 or a majority of > 4 separate cultures of blood (with first and last sample drawn at least 1 h apart) • Single positive blood culture for Coxiella burnetii or antiphase I IgG antibody titer > 1: 800 |
• Predisposition, predisposing heart condition or injection drug use • Fever, temperature 38º C • Vascular phenomena — Major arterial emboli — Septic pulmonary infarcts, — Mycotic aneurysm — Intracranial hemorrhage — Conjunctival hemorrhages — Janeway’s lesions • Immunologic phenomena — Glomerulonephritis — OSLER’S nodes — ROTH’S spots — Rheumatoid factor • Microbiological evidence: — Positive blood culture but does not meet a major criterion as noted above — Serological evidence of active infection with organism consistent with IE |
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Evidence of endocardial involvement A. Echocardiogram positive for IE, defined as follows: • Oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation; or • Abscess; or • New partial dehiscence of prosthetic valve B. New valvular regurgitation (worsening or changing of pre-existing murmur not sufficient) |
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Definite infective endocarditis • 2 major criteria or • 1 major criterion and 3 minor criteria or • 5 minor criteria Possible infective endocarditis • 1 major criterion and 1 minor criterion or • 3 minor criteria Rejected 1. Firm alternate diagnosis explaining evidence of infective endocarditis; or 2. Resolution of infective endocarditis syndrome with antibiotic therapy for ≤ 4 days 3. No pathologic evidence of infective endocarditis at surgery or autopsy, with antibiotic therapy for ≤ 4 days 4. Does not meet criteria for possible infective endocarditis, as above |
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IE = infective endocarditis; HACEK = Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella; IgG = immunoglobulin G. |
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