Duke Criteria for Infective Endocarditis (IE)
Major criteria:
A. Positive blood culture for Infective Endocarditis
1- Typical microorganism consistent with IE from 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
or
2- 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)
B. Evidence of endocardial involvement
1- Positive echocardiogram for IE defined as :
· 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
or
2- New valvular regurgitation (worsening or changing of preexisting murmur not sufficient)
Minor criteria:
- Predisposition: predisposing heart condition or intravenous drug use
- Fever: temperature > 38.0° C (100.4° F)
- Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway lesions
- Immunologic phenomena: glomerulonephritis, Osler's nodes, Roth spots, and rheumatoid factor
- Microbiological evidence: positive blood culture but does not meet a major criterion as noted above¹ or serological evidence of active infection with organism consistent with IE
- Echocardiographic findings: consistent with IE but do not meet a major criterion as noted above
Clinical criteria for infective endocarditis requires:
• Two major criteria, or
• One major and three minor criteria, or
• Five minor criteria
*HACEK group: Haemophilus sp, Actinobacilius actinomycetemcomitans, Cardiobacterium hominis, Eikenella rodens y Kingella sp
