Modified Duke criteria voor endocarditis

Modified Duke criteria voor endocarditis
Formal criteria to diagnose and stratify patients suspected of having infective endocarditis into ‘ definite’, ‘possible’ and ‘rejected’
Major clinical criteria
Positive blood culture for typical infective endocarditis organisms (S.viridans or S.bovis, HACEK, S.aureus without other primary site, Enterococcus), from 2 separate blood cultures or 2 positive cultures from samples drawn >12 hours apart, or 3 or a majority of 4 separate cultures of blood (first and last sample drawn 1 hour apart), single positive blood culture for Coxiella burnetii or anti-phase 1 IgG antibody titer >1:800
Echocardiogram with oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or an implanted material in the absence of an alternative anatomic explanation, or abscess, or new partial dehiscence of prosthetic valve or new valvular regurgitation
Single positive blood culture for Coxiella burnetii or anti-phase 1 IgG antibody titer >1:800
Minor clinical criteria
If all are positive, diagnosis is definite
Predisposing heart condition or intravenous drug use
Temp >38.0 C
Vascular phenomena: arterial emboli, pulmonary infarcts, mycotic aneursyms, intracranial bleed, conjunctival hemorrhages, Janeway lesions
Immunologic phenomena: glomerulonephritis, Osler nodes, Roth spots, rheumatoid factor
Microbiological evidence: positive blood culture but does not meet a major criterion or serological evidence of active infection with organism consistent with endocarditis (excluding coat neg staph, and other common contaminants)


Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization
of specific echocardiographic findings. Duke Endocarditis Service. American Journal of
. 96(3):200-9, 1994.