Duke Criteria for Infective Endocarditis

Question 1

What are the three categories of criteria for Duke’s?

Answer 1

Pathological

Major Clinical

Minor Clinical

Question 2

If _________of the pathological criteria are met, diagnosis is definite.

Answer 2

EITHER

Question 3

What are the two pathological criteria?

Answer 3

1. Microorganisms in a vegetation - culture or histological exam of a vegetation or intracardiac abscess specimen
2. Pathologic Lesions - Vegetation or intracardiac abscess confirmed by histologic exam showing active endocarditis.

Question 4

What are the two major clinical criteria?

Answer 4

1. blood cultures positive for endocarditis - microorganisms consistent with IE from 2 separate cultures; single positive culture for Coxiella burnetti or antiphase IgG ab titer >1:800.
2. Evidence of endoardial involvement - echo positive for IE, abscess, new valvular regurgitation, dehiscence of a prosthetic valve

Question 5

How many of the major clinical criteria do you need to make a diagnosis definite?

Answer 5

BOTH

Question 6

How many of the minor clinical criteria alone do you need to make the diagnosis definite?

Answer 6

​All 5

Question 7

What are the 5 minor clinical criteria?

Answer 7

1. predisposing heart condition or IV drug user
2. Fever
3. Vascular phenomenon -major arterial emboli; septic pulmonary infarcts; mycotic aneurysm; intracranial hemorrhage; conjunctival hemorrhages; Janeway’s lesions
4. Immunologic Phenomena - glomurelonephritis, Osler’s nodes, Roth’s spots and rheumatoid factor.
5. Micro evidence - positive blood culture that does not meet a major criterion or serological evidence of active infection with an organism consistent with IE.

Question 8

If you have one major criteria and one or two minor criteria, the diagnosis is __________?

Answer 8

Possible

Question 9

If you have one major criteria and three minor criteria, the diagnosis is ___________?

Answer 9

Definite

Question 10

What procedure should you do if Possible?

Answer 10

A TEE to see if you can make it definite

Question 11

IF you have three minor criteria, the diagnosis is ___________?

Answer 11

Possible

Question 12

What are Janeway lesions?

Answer 12

They are small, bruise-like spots on the palms of the hands and soles of the feet.

Osler’s nodes are similar but they are tender