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The Duke criteria are used to rule in or rule out endocarditis.
Endocarditis is felt to be present in the following conditions:
- Direct evidence of endocarditis based upon histological findings (a pathological criterion)
- Positive Gram stain results or cultures of specimens obtained from surgery or autopsy (a pathological criterion)
- 2 major clinical criteria
- 1 major and any 3 minor clinical criteria
- 5 minor clinical criteria
'Possible endocarditis' is defined by 1 major and 1 or 2 minor clinical criteria, OR 3 minor clinical criteria
The diagnosis of endocarditis is 'rejected' in any of the following cases:
- a firm alternate diagnosis is made
- clinical manifestations resolve after ≤4 days of antibiotic therapy
- no pathological evidence of infective endocarditis is found at surgery or autopsy after antibiotic therapy for ≤4 days
- fail to meet criteria for for possible or definite infective endocarditis
References
Beynon RP, Bahl VK, Prendergast BD.
Infective endocarditis.
BMJ 2006; 333; 334-339
Durack DT, Lukes AS, Bright DK.
New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings.
Am J Med.1994; 96 :200-209.
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 :633-638.
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