Updated (2023) Modified Duke Criteria for Infective Endocarditis

By admin

Infective endocarditis (IE) is a life-threatening condition and the Duke criteria (established in 1994 and revised in 2000) has been fundamental for the diagnosis of the disease. However, the landscape of micro-biology, diagnostics, epidemiology, and treatment for lE has evolved significantly over the years. The 2023 modified Duke criteria address these changes:

  1. Incorporation of advanced microbiological techniques such as PCR and genomic sequencing.
  2. Introducing surgical inspection as a major diagnostic criterion.
  3. Eliminating the need for separate venipunctures and specific timings for blood culture.
  4. Utilizing Cardiac CT and FDG PET/CT for enhanced imaging.
  5. Including splenic and cerebral abscesses as vascular manifestations.
  6. Recognizing regurgitant murmurs via physical examination as a diagnostic indicator.

The diagnostic criteria for IE are divided into 3 categories:

I. Definite endocarditis

A. Pathologic Criteria

B. Clinical Criteria:

  • 2 Major criteria OR
  • 1 Major criterion and 3 minor criteria OR
  • 5 Minor criteria

Il. Possible endocarditis

A. Clinical criteria only

  • 1 Major criterion and 1 minor criterion
  • 3 Minor criteria

IlI. Rejected endocarditis

A. Firm alternate diagnosis explaining signs/symptoms OR
B. Lack of recurrence despite antibiotic therapy for less than 4 days OR
C. No pathologic or macroscopic evidence of IE at surgery or autopsy, with antibiotic therapy for less than 4 days OR
D. Does not meet criteria for possible IE, as above

Updated (2023) Modified Duke Criteria for Infective Endocarditis:

updated 2023 modified duke criteria for infective endocarditis


_Updating_the Modified_Duke_Criteria#:~:text=The

Spread the love


Leave a Comment