The Cardiovascular
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2023 Duke-ISCVID criteria for infective endocarditis

Classifies suspected endocarditis as definite, possible or rejected.

2023 Duke-ISCVID criteria for infective endocarditis
Number of major criteria met
Positive blood cultures for typical organisms, imaging/PET evidence of endocardial involvement, or surgically/pathologically confirmed lesions.
Number of minor criteria met
Predisposition, fever >=38 C, vascular phenomena, immunologic phenomena, suggestive microbiology, or suggestive imaging not meeting a major criterion.
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When to use

  • Classifying patients with suspected infective endocarditis for research or clinical decision-making.

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

  • The 2023 revision adds intraoperative inspection as a major criterion and expands the list of typical organisms and imaging modalities (FDG-PET/CT, cardiac CT).
  • Pathologic criteria (organisms or active endocarditis in a specimen) independently establish definite IE regardless of the clinical count.

References

  1. Fowler VG, et al. Clin Infect Dis. 2023;77(4):518-526.