Prevention the endocarditis team diagnosis definition of the terms used in the esc 2015 modified criteria for diagnosis of ie, with modifications in main principles of prevention of infective endocarditis boldface 1. Appropriate use of transesophageal echocardiogram for. We evaluated the usefulness of the duke criteria for diagnosing cases of active infective endocarditis ie. The accepted criteria for diagnosis of ie are the modified. Baddour et al infective endocarditis in adults 1437 a diagnosis of ie with the original duke criteria was based on the presence of either major or minor clinical criteria tables 2 and 3. Assessment of the usefulness of the duke criteria for. Pdf proposed modifications to the duke criteria for the. The duke criteria should be used as overview of management of infective endocarditis in adults. They should be essential in everyday clinical decision making. List the risk factors for infective endocarditis ie. Endocarditis modified duke criteria unclassified pacific partnership 2016 j am soc echocardiogr 2012. The duke ie database contains records collected prospectively on 800 cases of definite and possible ie since 1984.
Many studies have now demonstrated the superiority of the duke criteria and a recent scientific statement of the american heart association concluded that they should be adopted as the primary diagnostic schema in the clinical evaluation of patients in whom infective endocarditis is suspected. Retrospective case study in a tertiary pediatric hospital. Suspect ie and consider the duke criteria in patients with. Mobeen presents modified dukes criteria to diagnose definitively, or to suspect, or to.
According to the duke criteria, diagnosis of infective endocarditis can be definite, possible, or rejected. Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults. Infective endocarditis is a relatively uncommon disease with a high mortality rate. Infective endocarditis is the result of infection of the endocardium internal lining of the heart and of the heart valves. Patients with infective endocarditis are a heterogenous group. Assesment of the duke criteria for the diagnosis of. Click on the image or right click to open the source website in a new browser window. To compare the sensitivity of 3 different criteriavon reyn, duke, and modified dukein diagnosing infective endocarditis ie in children. Many studies have now demonstrated the superiority of the duke. The duke criteria table 1,6 based upon clinical, echocardiographic and microbiological. What is the role of the duke diagnostic criteria in. Duke criteria for infectious endocarditis diagnosis.
Pathologic criteria are histological or culture confirmation ofpathologic criteria are histological or culture confirmation of vegetation or emboli. The duke diagnostic criteria, developed by durack and colleagues, are generally used to make a definitive diagnosis of ie. Many studies have now demonstrated the superiority of. Antibiotic treatment of infec tious endocarditis depends on whether the involved valve is native or. Echocardiography minor criteria eliminated predisposition heart condition or iv drug user 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. Modified duke criteria definite infective endocarditis clinical criteria 2 major criteria, or 1 major criterion and 3 minor criteria, or 5 minor criteria major criteria blood culture positive typical microorganism for ie multiple variations endocarditis by imaging study circulation 2005. Minor criterion includes predisposing heart condition or iv drug use, fever, vascular phenomena, immunologic phenomena, microbiological. Endocarditis diagnostic criteria duke criteria calculator. The duke criteria for endocarditis are summarized below. Esc clinical practice guidelines aim to present all the relevant evidence to help physicians weigh the benefits and risks of a particular diagnostic or therapeutic procedure on infective endocarditis. Duke criteria for infective endocarditis durack dt, lukes as, bright dk. Modified dukes criteria to diagnose acute infective.
The duke criteria are a set of clinical criteria set forward for the diagnosis of infective endocarditis. Infective endocarditis an overview sciencedirect topics. Current clinical guidelines for the diagnosis and management of ie recommend the use of modified duke criteria. Echocardiogram supportive of infective endocarditis. The criteria combine the clinical, microbiologic, pathologic, and. The purpose of this survey was to elaborate clinicians knowledge and opinion on relevant heart conditions as a duke minor criterion for the diagnosis of ie. Greatest morbidity occurs among those with recent cardiac prostheses, statuspost heart transplant, or prior endocarditis. These images are a random sampling from a bing search on the term duke criteria for infectious endocarditis diagnosis. The duke criteria for infective endocarditis provides standardized diagnostic criteria for endocarditis. The most common cause of infection was staphylococcus aureus in 28% of patients. Endocarditis diagnostic criteria modified duke criteria. These were originally proposed in 1994 to help establish the diagnosis of endocarditis. Guidelines for the diagnosis and antibiotic treatment of.
New criteria for diagnosis of infective endocarditis. Evaluation of the duke criteria in 93 episodes of prosthetic. The endocarditis diagnostic duke criteria calculator evaluates both major and minor diagnostic criteria. Duke criteria for the diagnosis of endocarditis definite. Proposed modifications to the duke criteria for the diagnosis of infective endocarditis. It is the dedication of healthcare workers that will lead us through this crisis.
The presentation, clinical course, and approach to treatment can vary widely based on. Despite improved medical and surgical advances, the. Modified dukes criteria for infective endocarditis. European association for cardiothoracic surgery eacts, the european association of nuclear medicine eanm. Infective endocarditis ie refers to infection of the endocardial surface of the heart. In the absence of classical features fever, cardiac murmur, and peripheral vascular stigmata the diagnosis of infective endocarditis ie may be difficult.
Determine the appropriate laboratory tests and imaging necessary to aid in diagnosing ie. The modified duke criteria stratify patients into the following categories. The duke criteria gave diagnostic weight to bacteremia with staphylococci or enterococci only, on the basis of the location of acquisition and with. Although the sensitivity and specificity of the duke criteria for the diagnosis of infective endocarditis ie have been validated by investigators from europe and the united states, several. University of pennsylvania health system antimicrobial use. The term predisposing heart condition is used as an indication of antimicrobial prophylaxis to prevent infective endocarditis ie and as a criterion for diagnosing ie according to modified duke criteria. Clinical criteria for definite endocarditis requires two major criteria, or one major and three minor criteria, or five minor criteria. Major criterion includes positive blood culture for typical infective endocarditis organisms, and echocardiogram with oscillating intracardiac mass. Acute infective endocarditis aie is a difficult disease to suspect and diagnose. Although the sensitivity and specificity of the duke criteria for the diagnosis of infective endocarditis ie have been validated by investigators from europe and the.
For adequate diagnostic sensitivity, transesophageal echocardiography is the preferred modality used in patients. Recognize the signs, symptoms, and duke criteria that aid in the diagnosis of ie. Positive blood culture for typical infective endocarditis organisms s. Interestingly, in 20% of the cases, there was no cardiology consultation prior to the tee, and in 20% of the cases, there was no documented bacteremia table 2. Clinical criteria are 2 major, 1 major plus 3 minor or 5 minor criteria e. Established in 1994 by the duke endocarditis service and revised in 2000, the duke criteria are a collection of major and minor criteria used to establish a diagnosis of infective endocarditis. Endocarditis continues to have a high mortality, estimated at 1020% among hospitalized patients. Between 1985 and 2001, 41 episodes of ie were documented in 40 children median. Tee recommended as first test in the following patients. The duke criteria for the diagnosis of endocarditis include either two major criteria i. Patients were identified prospectively over a 3year period at 54 hospitals in the philadelphia metropolitan area. A wide variety of pathogens may cause infective endocarditis, and some cases are culture negative. Diagnostic criteria and problems in infective endocarditis. Although the sensitivity and specificity of the duke criteria for the diagnosis of infective endocarditis ie have been validated by investigators from europe and the united states, several shortcomings of this schema remain.
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