Duke Criteria for Infective Endocarditis - MDCalc

Duke Criteria for Infective Endocarditis · Prolonged fever (Fever of Unknown Origin) · Fever and vascular phenomena (stroke, limb ischemia, physical findings of ... Thisisanunprecedentedtime.Itisthededicationofhealthcareworkersthatwillleadusthroughthiscrisis.Thankyouforeverythingyoudo.COVID-19ResourceCenterCalcFunctionCalcsthathelppredictprobabilityofadiseaseDiagnosisSubcategoryof'Diagnosis'designedtobeverysensitiveRuleOutDiseaseisdiagnosed:prognosticatetoguidetreatmentPrognosisNumericalinputsandoutputsFormulaMedtreatmentandmoreTreatmentSuggestedprotocolsAlgorithmDiseaseSelect...SpecialtySelect...ChiefComplaintSelect...OrganSystemSelect...PatentPendingLogInEmailAddressPasswordShowForgotyourpassword?LogInOrcreateanewaccount(it'sfree)ForgotPassword?EmailAddressEnteryouremailaddressandwe'llsendyoualinktoresetyourpassword.GetNewPasswordSignInRequiredTosavefavorites,youmustlogin.Creatinganaccountisfree,easy,andtakesabout60seconds.LogInCreateAccountAttentionCOACHSTUDYparticipants:Theprincipalinvestigatorsofthestudyrequestthatyouusetheofficialversionofthemodifiedscorehere.Logintocreatealistofyourfavoritecalculators!LoginYear-endCMEspecial!Get$150offonselectCMEpackageswithcodeNEWYEARSignUpDukeCriteriaforInfectiveEndocarditisDiagnosticcriteriaforendocarditis.WhentoUsePearls/PitfallsWhyUseSuspectIEandconsidertheDukeCriteriainpatientswith:Prolongedfever(FeverofUnknownOrigin)Feverandvascularphenomena(stroke,limbischemia,physicalfindingsofsepticemboli)Persistentlypositivebloodcultures(2ormore).Prostheticvalveswhoarefebrile.Injectiondruguserswhoarefebrile.Apre-disposingheartconditionwhoarefebrile.Feverwitharecenthistoryofhospitalization.Formalcriteriatodiagnoseandstratifypatientssuspectedofhavinginfectiveendocarditis(IE)into“definite”,“possible”,and“rejected”.ShouldbeappliedtopatientsinwhomthereisahighclinicalsuspicionofIE.Negativeculturesmaybeconfoundedbyarecenthistoryoftreatmentwithantibiotics.TheIEMortalityRiskScorecanhelpriskstratifypatients'6monthoutcomeonceIEisconfirmed.PatientswithIEcanhaveawiderangeofclinicalfeaturesandthediagnosiscanbechallenging.Thiscriteriaissensitivefordiseasedetection,andhasahighnegativepredictivevalue.PathologicalCriteriaIfeitherispositive,diagnosisisdefinite(seeEvidenceforexceptions)MicroorganismsinavegetationDemonstratedbycultureorhistologicexaminationofavegetation,avegetationthathasembolized,oranintracardiacabscessspecimen.PathologicLesionsVegetationorintracardiacabscessconfirmedbyhistologicexaminationshowingactiveendocarditis.MajorClinicalCriteriaIfbotharepositive,diagnosisisdefinite(seeEvidenceforexceptions)BloodculturespositiveforendocarditisTypicalmicroorganismsconsistentwithIEfrom2separatebloodcultures,microorganismsconsistentwithIEfrompersistentlypositivebloodcultures,singlepositivebloodcultureforCoxiellaburnetiiorantiphaseIIgGantibodytiter>1:800.EvidenceofendocardialinvolvementEchocardiogrampositiveforIE,abscess,newpartialdehiscenceofprostheticvalve,newvalvularregurgitation.Note:Worseningorchangingofpre-existingmurmurNOTsufficient.MinorClinicalCriteriaIfallarepositive,diagnosisisdefinite(seeEvidenceforexceptions)PredisposingheartconditionorinjectiondruguseFeverVascularphenomenaMajorarterialemboli,septicpulmonaryinfarcts,mycoticaneurysm,intracranialhemorrhage,conjunctivalhemorrhages,andJaneway’slesions.ImmunologicphenomenaGlomerulonephritis,Osler’snodes,Roth’sspots,andrheumatoidfactor.MicrobiologicalevidencePositivebloodculturebutdoesnotmeetamajorcriterionasnotedaboveorserologicalevidenceofactiveinfectionwithorganismconsistentwithIE.DiagnosticResult:Pleasefilloutrequiredfields.NextStepsEvidenceCreatorInsightsDr.DavidDurackAbouttheCreatorDavidDurack,MD,isaninfectiousdiseasespecialistwhoisaffiliatedwithDukeUniversityHospitalandhaspracticedfor46years.HereceivedhismedicaldegreefromUniversityofWesternAustraliaFacultyofMedicine.Dr.Durack'sclinicalinterestsincludepublichealth,endocarditis,meningitis,septicemia,MRSA,influenza,andvaccines.ToviewDr.DavidDurack'spublications,visitPubMedAreyouDr.DavidDurack?Sendusamessagetoreviewyourphotoandbio,andfindouthowtosubmitCreatorInsights!MDCalclovescalculatorcreators–researcherswho,throughintelligentandoftencomplexmethods,discovertoolsthatdescribescientificfactsthatcanthenbeappliedinpractice.Thesearerealscientificdiscoveriesaboutthenatureofthehumanbody,whichcanbeinvaluabletophysicianstakingcareofpatients.ContentContributorsPranayAryal,MDRelatedCalcsIEMortalityRiskScoreJonesCriteriaforARFDRIPScoreHavefeedbackaboutthiscalculator?AbouttheCreatorDr.DavidDurackAreyouDr.DavidDurack?AlsofromMDCalc...RelatedCalcsIEMortalityRiskScoreJonesCriteriaforARFDRIPScoreYoumightbeinterestedin...PartnerContentCalculatedDecisions:DukeCriteriaforIEEmergencyMedicinePracticeContentContributorsPranayAryal,MD