About Epomedicine Contact Us Author Guidelines ✒️Submit Article Editors & Authors

🔬 Covid-19 Resources Thesis Ask Epomedicine

MEDICAL STUDENTS BEDSIDE CLINICS CASE REPORTS

EMERGENCY MEDICINE BLOG SURGICAL SKILLS MEDICAL MNEMONICS

USMLE, PGMEE, MBBS, MD/MS

Modified Duke’s Criteria for

Infective Endocarditis : Mnemonic

📑 Cardiovascular system Internal medicine Pediatrics
Last modified: Oct 22, 2017

Table of Contents [hide]

A. Major Criteria
1. Blood culture positive
2. Evidence of Endocardial involvement
B. Minor criteria
Definitive Infective Endocarditis (IE)
Possible Infective Endocarditis (IE)

Bacterial Endocarditis FIVE PM, i.e. BE FIVE PM

1. Blood culture positive for IE

2. Endocardial involvement
3. Fever
4. Immunologic phenomena
5. Vascular phenomena
 6. Echocardioraphy minor criteria (eliminated)
7. Predisposition
8. Microbiologic evidence

Definite Diagnosis from Clinical Criteria:

2 (major) + 0 (minor) or
1 (major) + 3 (minor) or
0 (major) + 5 (minor)

Look: when major criteria decreases,

subsequently minor criteria increases by odd
number.

A. Major Criteria

1. Blood culture positive

a. Typical micro-organisms consistent with IE from 2

separate blood cultures – S. aureus, S. viridans, S. bovis
(gallolyticus), HACEK group, Community acquired
enterococci, in the absence of primary foci OR

b. Persistently positive blood culture:

 For organisms that are typical causes of IE: ≥2 positive
blood cultures from blood samples drawn >12 hours
apart
For organisms that are more commonly skin
contaminants: 3 or a majority of ≥4 separate blood
cultures (with first and last drawn atleast 1 hour apart)

c. Single positive blood culture for Coxiella burnetii or phase

I IgG antibody titre >1:800

2. Evidence of Endocardial involvement

a. Positive echocardiogram (vegetation, abscess or valve

dehiscence) or

b. New valvular regurgitation (increase or change in pre-

existing murmur)

B. Minor criteria
1. Fever > 38ºc
2. Immunologic phenomena (glomerulonephritis, Osler’s
nodes, Roth’s spots, Rheumatoid factor)
3. Vascular phenomena (major arterial emboli, septic
pulmonary infarcts, mycotic aneurysm, intracranial
hemorrhage, conjuntival hemorrhage, Janeway lesions)
4. (Echocardiography minor criteria eliminated)
5. Predisposition (heart condition or IV drug user)
6. 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)
Pathologic criteria:
Histologic evidence of active endocarditis – vegetation or
intracardiac abscess OR
Microorganism demonstrated on culture or histology of
vegetation or intracardiac abscess

Clinical criteria:

2 Major OR
1 Major + 3 Minor
5 Minor

Possible Infective Endocarditis

(IE)
1 Major + 1 Minor OR

3 Minor

Suggested Reading and Resources:

Approach to a Child Atropine Induced

with Short Stature Paradoxical
Bradycardia

Pregabalin : ECG Guide for

Pharmacology Surgeons
 Perioperative
Management of
Venous
thromboembolism
(VTE)

This site uses Akismet to reduce spam. Learn how your

comment data is processed.