{"id":57,"date":"2009-02-26T18:33:48","date_gmt":"2009-02-26T18:33:48","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/carendocarditis\/"},"modified":"2025-05-14T21:00:52","modified_gmt":"2025-05-14T21:00:52","slug":"carendocarditis","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/carendocarditis\/","title":{"rendered":"Modified Duke Criteria for the Clinical Diagnosis of Infective Endocarditis (IE)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">The diagnosis of infective endocarditis is generally based on clinical, microbiologic, and echocardiographic findings. The Duke criteria have sensitivity and specificity of more than 80% and are the reference criteria for diagnosis.<\/p>\n<p><!--more--><\/p>\n<p><strong>Modified Duke Criteria for the Clinical Diagnosis of Infective Endocarditis<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Major criteria:<\/strong><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">A. Positive blood culture for Infective Endocarditis<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; margin-top: 0pt; margin-bottom: 0pt;\">1- Typical microorganism consistent with IE from 2 separate blood cultures, as noted below:<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\">\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\">viridans streptococci, Streptococcus bovis, or HACEK* group, or<\/p>\n<\/li>\n<li class=\"MsoNormal\">\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\">community-acquired Staphylococcus aureus or enterococci, in the absence of a primary focus<\/p>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; margin-top: 0pt; margin-bottom: 0pt;\">or<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; margin-top: 0pt; margin-bottom: 0pt;\">2- Microorganisms consistent with IE from persistently positive blood cultures defined as:<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\">\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\">2 positive cultures of blood samples drawn &gt;12 hours apart, or<\/p>\n<\/li>\n<li class=\"MsoNormal\">\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\">all of 3 or a majority of 4 separate cultures of blood (with first and last sample drawn 1 hour apart)<\/p>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">B. Evidence of endocardial involvement<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; margin-top: 0pt; margin-bottom: 0pt;\">1- Positive echocardiogram for IE defined as :<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; text-indent: 0cm; margin-top: 0pt; margin-bottom: 0pt; padding-left: 40px;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>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<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; text-indent: 0cm; margin-top: 0pt; margin-bottom: 0pt; padding-left: 40px;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>abscess, or<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; text-indent: 0cm; margin-top: 0pt; margin-bottom: 0pt; padding-left: 40px;\"><span style=\"font-family: Symbol;\">\u00b7 <\/span>new partial dehiscence of prosthetic valve<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; margin-top: 0pt; margin-bottom: 0pt;\">or<\/p>\n<p class=\"MsoNormal\" style=\"margin-left: 18pt; margin-top: 0pt; margin-bottom: 0pt;\">2- New valvular regurgitation (worsening or changing of preexisting murmur not sufficient)<\/p>\n<p class=\"MsoNormal\"><strong>Minor criteria: <\/strong><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\">Predisposition: predisposing heart condition or intravenous drug use<\/li>\n<li class=\"MsoNormal\">Fever: temperature &gt; 38.0\u00b0 C (100.4\u00b0 F)<\/li>\n<li class=\"MsoNormal\">Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway lesions<\/li>\n<li class=\"MsoNormal\">Immunologic phenomena: glomerulonephritis, Osler&#8217;s nodes, Roth spots, and rheumatoid factor<\/li>\n<li class=\"MsoNormal\">Microbiological evidence: positive blood culture but does not meet a major criterion as noted above\u00b9 or serological evidence of active infection with organism consistent with IE<\/li>\n<li class=\"MsoNormal\">Echocardiographic findings: consistent with IE but do not meet a major criterion as noted above<\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Clinical criteria for infective endocarditis requires: <\/strong><\/p>\n<ul>\n<li class=\"MsoNormal\">Two major criteria, or<\/li>\n<li class=\"MsoNormal\">One major and three minor criteria, or<\/li>\n<li class=\"MsoNormal\">Five minor criteria<\/li>\n<\/ul>\n<p class=\"MsoNormal\">*HACEK group: <em>Haemophilus sp, Actinobacilius actinomycetemcomitans, Cardiobacterium hominis, Eikenella rodens y Kingella sp<\/em><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<p class=\"MsoNormal\"><strong>References :<\/strong><\/p>\n<ol style=\"margin-top: 0cm;\">\n<li>Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service. Am J Med. 1994 Mar;96(3):200-9.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/8154507\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Hoen B, Duval X. Clinical practice. Infective endocarditis. N Engl J Med. 2013 Apr 11;368(15):1425-33.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23574121\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Chambers HF, Bayer AS. Native-Valve Infective Endocarditis. N Engl J Med. 2020;383(6):567-576. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32757525\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<\/div>\n<div><\/div>\n<div class=\"Section1\">Created: July 14, 2005<\/div>\n<div>Update: Aug 12, 2020<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[26],"tags":[1348,490,16,15,123,1826,1825,1824,1823,1344,1827,669],"class_list":["post-57","post","type-post","status-publish","format-standard","hentry","category-cardiology","tag-cardiology","tag-clinical","tag-criteria","tag-criterios","tag-diagnosis","tag-duke","tag-endocarditis","tag-ie","tag-infecciosa","tag-infectious","tag-infective","tag-modified"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/57","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=57"}],"version-history":[{"count":6,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/57\/revisions"}],"predecessor-version":[{"id":9396,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/57\/revisions\/9396"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=57"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=57"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=57"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}