Monday, May 9, 2016

Diagnosis of Infective Endocarditis ( Duke's Criteria )

Hello Everyone!

Today, I read about a case of Infective Endocarditis, and it came up with something interesting! A definite way to diagnose a typical case of IE is by Modified Duke's Criteria -

           1. Positive blood cultures
                         ○ Typical organisms in Two blood cultures
                         ○ Persistent positive blood cultures taken >12 hours apart
                         ○ Three or more positive cultures taken over more than 1 hour
           2. Endocardial involvement
                         ○ Positive echocardiographic findings of vegetations
                         ○ New valvular regurgitation

( Priya Found Emban In the BalCony. )
         1. Predisposing factors (any cardiac abnormality, hypertension, valvular defect, congenital heart disease, i.v. drug abuse)
          2. Fever >38°C
          3. Embolic phenomenon (Embolus formation in Lungs, Brain, Spleen)
          4. Immunological phenomenon (Vasculitis, Glomerular Nephritis)
          5. Blood Cultures positive - organisms grown but not fulfilling major criteria.
For definitive IE, the simple rule is

☆ 2 major and No minor criteria (2-0)
☆ 1 major and 3 minor criteria (1-3)
☆ No major and 5 minor criteria (0-5)

That's all!
Thanks :)


  1. Awesome. What are the ECG findings you are talking about?

    1. Sometimes, AV block may occur due to presence of ring abscess of the aortic valve, when it invades posteriorly and involves the conduction system. This would result in a prolonged PR interval.

      ECG findings lack sensitivity and specificity.

      We did a typing boo boo. Sorry for that :D

    2. Transthoracic echo is done to detect vegetations in the valve that may be as small as 1-1.5mm!
      If not detectable, it does not exclude the possibility of IE.

      That was a typing error! Really sorry for that.. :)


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