Modified duke criteria definite infective endocarditis clinical criteria 2 major criteria, or 1 major criterion and 3 minor criteria, or 5 minor criteria major criteria blood culture positive typical microorganism for ie multiple variations endocarditis by imaging study circulation 2005. Assessment of the usefulness of the duke criteria for. Proposed modifications to the duke criteria for the diagnosis of infective endocarditis. The criteria combine the clinical, microbiologic, pathologic, and. Infective endocarditis is the result of infection of the endocardium internal lining of the heart and of the heart valves. Duke criteria for infective endocarditis durack dt, lukes as, bright dk. Diagnostic criteria and problems in infective endocarditis. Endocarditis modified duke criteria unclassified pacific partnership 2016 j am soc echocardiogr 2012. Although the sensitivity and specificity of the duke criteria for the diagnosis of infective endocarditis ie have been validated by investigators from europe and the united states, several shortcomings of this schema remain. Tee recommended as first test in the following patients.
Guidelines for the diagnosis and antibiotic treatment of. The duke criteria should be used as overview of management of infective endocarditis in adults. The duke ie database contains records collected prospectively on 800 cases of definite and possible ie since 1984. Baddour et al infective endocarditis in adults 1437 a diagnosis of ie with the original duke criteria was based on the presence of either major or minor clinical criteria tables 2 and 3. The accepted criteria for diagnosis of ie are the modified. Clinical criteria are 2 major, 1 major plus 3 minor or 5 minor criteria e. Positive blood culture for typical infective endocarditis organisms s. The duke criteria for endocarditis are summarized below. Endocarditis continues to have a high mortality, estimated at 1020% among hospitalized patients. Acute infective endocarditis aie is a difficult disease to suspect and diagnose.
The purpose of this survey was to elaborate clinicians knowledge and opinion on relevant heart conditions as a duke minor criterion for the diagnosis of ie. Evaluation of the duke criteria in 93 episodes of prosthetic. Pathologic criteria are histological or culture confirmation ofpathologic criteria are histological or culture confirmation of vegetation or emboli. According to the duke criteria, diagnosis of infective endocarditis can be definite, possible, or rejected.
We evaluated the usefulness of the duke criteria for diagnosing cases of active infective endocarditis ie. Assesment of the duke criteria for the diagnosis of. The presentation, clinical course, and approach to treatment can vary widely based on. Prevention the endocarditis team diagnosis definition of the terms used in the esc 2015 modified criteria for diagnosis of ie, with modifications in main principles of prevention of infective endocarditis boldface 1. Echocardiogram supportive of infective endocarditis.
These images are a random sampling from a bing search on the term duke criteria for infectious endocarditis diagnosis. The most common cause of infection was staphylococcus aureus in 28% of patients. Modified dukes criteria to diagnose acute infective. Echocardiography minor criteria eliminated predisposition heart condition or iv drug user microbiologic evidence positive blood culture but not meeting major criteria or serologic evidence of active infection with organism consistet with ie definitive infective endocarditis ie. Mobeen presents modified dukes criteria to diagnose definitively, or to suspect, or to. The duke criteria for infective endocarditis provides standardized diagnostic criteria for endocarditis. The duke criteria for the diagnosis of endocarditis include either two major criteria i. Many studies have now demonstrated the superiority of the duke. Greatest morbidity occurs among those with recent cardiac prostheses, statuspost heart transplant, or prior endocarditis.
Suspect ie and consider the duke criteria in patients with. To compare the sensitivity of 3 different criteriavon reyn, duke, and modified dukein diagnosing infective endocarditis ie in children. These were originally proposed in 1994 to help establish the diagnosis of endocarditis. Duke criteria for infectious endocarditis diagnosis. Antibiotic treatment of infec tious endocarditis depends on whether the involved valve is native or.
Infective endocarditis is a relatively uncommon disease with a high mortality rate. The modified duke criteria stratify patients into the following categories. New criteria for diagnosis of infective endocarditis. Many studies have now demonstrated the superiority of the duke criteria and a recent scientific statement of the american heart association concluded that they should be adopted as the primary diagnostic schema in the clinical evaluation of patients in whom infective endocarditis is suspected. European association for cardiothoracic surgery eacts, the european association of nuclear medicine eanm.
Recognize the signs, symptoms, and duke criteria that aid in the diagnosis of ie. Despite improved medical and surgical advances, the. Determine the appropriate laboratory tests and imaging necessary to aid in diagnosing ie. Patients with infective endocarditis are a heterogenous group. Duke criteria for the diagnosis of endocarditis definite. What is the role of the duke diagnostic criteria in. The duke criteria gave diagnostic weight to bacteremia with staphylococci or enterococci only, on the basis of the location of acquisition and with. They should be essential in everyday clinical decision making. List the risk factors for infective endocarditis ie. Patients were identified prospectively over a 3year period at 54 hospitals in the philadelphia metropolitan area.
Many studies have now demonstrated the superiority of. Endocarditis diagnostic criteria duke criteria calculator. Click on the image or right click to open the source website in a new browser window. For adequate diagnostic sensitivity, transesophageal echocardiography is the preferred modality used in patients.
The term predisposing heart condition is used as an indication of antimicrobial prophylaxis to prevent infective endocarditis ie and as a criterion for diagnosing ie according to modified duke criteria. Although the sensitivity and specificity of the duke criteria for the diagnosis of infective endocarditis ie have been validated by investigators from europe and the. Minor criterion includes predisposing heart condition or iv drug use, fever, vascular phenomena, immunologic phenomena, microbiological. Pdf proposed modifications to the duke criteria for the. Although the sensitivity and specificity of the duke criteria for the diagnosis of infective endocarditis ie have been validated by investigators from europe and the united states, several. University of pennsylvania health system antimicrobial use. Duke criteria for infective endocarditis radiology. Infective endocarditis ie refers to infection of the endocardial surface of the heart. The duke criteria table 1,6 based upon clinical, echocardiographic and microbiological. Endocarditis diagnostic criteria modified duke criteria. Clinical criteria for definite endocarditis requires two major criteria, or one major and three minor criteria, or five minor criteria.
Major criterion includes positive blood culture for typical infective endocarditis organisms, and echocardiogram with oscillating intracardiac mass. In the absence of classical features fever, cardiac murmur, and peripheral vascular stigmata the diagnosis of infective endocarditis ie may be difficult. Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults. Retrospective case study in a tertiary pediatric hospital. Interestingly, in 20% of the cases, there was no cardiology consultation prior to the tee, and in 20% of the cases, there was no documented bacteremia table 2. The duke criteria are a set of clinical criteria set forward for the diagnosis of infective endocarditis. Modified dukes criteria for infective endocarditis. Appropriate use of transesophageal echocardiogram for. Esc clinical practice guidelines aim to present all the relevant evidence to help physicians weigh the benefits and risks of a particular diagnostic or therapeutic procedure on infective endocarditis. The duke diagnostic criteria, developed by durack and colleagues, are generally used to make a definitive diagnosis of ie. Infective endocarditis an overview sciencedirect topics. The endocarditis diagnostic duke criteria calculator evaluates both major and minor diagnostic criteria. It is the dedication of healthcare workers that will lead us through this crisis.