The Cardiovascular
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Modified Duke Criteria for Infective Endocarditis

Classifies suspected endocarditis as definite, possible, or rejected.

Modified Duke Criteria for Infective Endocarditis
Major: typical positive blood cultures for IE
Major: evidence of endocardial involvement (echo/new regurgitation)
Minor: predisposing heart condition or IV drug use
Minor: fever >=38 C
Minor: vascular phenomena
Minor: immunologic phenomena
Minor: microbiological evidence not meeting a major criterion
ResultRejected

Criteria for infective endocarditis are not met.

Major criteria
0
Minor criteria
0

When to use

  • Classifying the likelihood of infective endocarditis in a suspected case.

Formula

Definite: 2 major, or 1 major + 3 minor, or 5 minor. Possible: 1 major + 1 minor, or 3 minor. Otherwise rejected.

Pearls and pitfalls

  • Pathologic criteria (positive vegetation histology/culture) independently confirm definite IE.
  • Two major criteria: typical positive cultures and echocardiographic endocardial involvement.

References

  1. Li JS, et al. Clin Infect Dis. 2000;30(4):633-8.