Duke Criteria for Infective Endocarditis

Microorganisms in a vegetation

• Demonstrated by culture or histologic examination of a vegetation, a vegetation that has embolized, or an intracardiac abscess specimen

Pathologic Lesions

• Vegetation or intracardiac abscess confirmed by histologic examination showing active endocarditis

Blood cultures positive for endocarditis

• Typical microorganisms consistent with IE from 2 separate blood cultures?
• Microorganisms consistent with IE from persistently positive blood cultures?
• Single positive blood culture for Coxiella burnetii or antiphase I IgG antibody titer >1:800

Evidence of endocardial involvement

• Echocardiogram positive for IE
• Abscess
• New partial dehiscence of prosthetic valve
• New valvular regurgitation
• Note: Worsening or changing of pre-existing murmur NOT sufficient

Predisposing heart condition or injection drug use

Fever

Vascular phenomena

• Major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway’s lesions

Immunologic phenomena

• Glomerulonephritis, Osler's nodes, Roth's spots, and rheumatoid factor

Microbiological evidence

• Positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE