Duke Criteria
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Background
Diagnostic criteria for Infectious Endocarditis originally proposed in 1994[1]. Based on combination of echo, laboratory, and physical examination findings.
Criteria
Major criteria:
- Bacteremia with typical organisms
- 2 separate blood cultures, as noted below:
- viridans streptococci, Streptococcus bovis, or HACEK group or community-acquired Staphylococcus aureus or enterococci, in the absence of a primary focus
- Microorganisms consistent with IE from persistently positive blood cultures defined as:
- 2 positive cultures of blood samples drawn >12 hours apart, or all of 3 or a majority of 4 separate cultures of blood (with first and last sample drawn 1 hour apart)
- Echocardiographic findings
- Vegetations
- Abscesses
- Valve dehiscence – prosthetic valves
- New valvular regurgitation
- Echocardiography has become the major mode of diagnosis, especially if blood cultures are negative.
Minor Criteria:
- Predisposing condition, IVDA
- Fever > 38
- Vascular phenomena
- Arterial embolism
- Septic pulmonary infarcts
- Mycotic aneurysm
- Intracranial hemorrhage
- Janeway lesions
- Immunologic phenomena
- Glomerulonephritis
- Osler nodes
- Roth spots
- Echocardiographic findings: consistent with IE but do not meet a major criterion as noted above
Diagnosis
Clinical criteria for infective endocarditis requires:
- Two major criteria, or
- One major and three minor criteria, or
- Five minor criteria
References
- ↑ Durack DT, Lukes AS, Bright DK. Am J Med 96:200-209, 1994.
