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| Endocarditis Diagnostic Criteria -- Modified Duke Criteria |
The EBMcalc module Endocarditis Diagnostic Criteria -- Modified Duke Criteria is available in EBMcalc Complete Edition.
This calculator evaluates the following Clinical Criteria:
- Positive blood culture for typical infective endocarditis organisms (S. viridans or S. bovis, HACEK organisms, 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)
- Echocardiogram with oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on 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
- Predisposing heart condition or intravenous drug use
- Temp >38 degrees C (100.4 degrees F)
- Vascular phenomena: arterial emboli, pulmonary infarcts, mycotic aneurysms, 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 as noted above or serological evidence of active infection with organism consistent with endocarditis (excluding coag neg staph, and other common contaminants)
References
- 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. PubMed ID: 8154507
- Lukes AS, Bright DK, Durack DT. Diagnosis of infective endocarditis. Infect Dis Clin North Am. 1993 Mar;7(1):1-8. Review. PubMed ID: 8463647
- Fournier PE, Casalta JP, Habib G, et al. Modification of the diagnostic criteria proposed by the Duke Endocarditis Service to permit improved diagnosis of Q fever endocarditis. Am J Med. 1996; 100:629. PubMed ID: 8678083
- Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000; 30:633. PubMed ID: 10770721
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