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)

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