Modified Duke Criteria
Diagnosis of Infective Endocarditis
This calculator is a support tool intended exclusively for health professionals. It does not replace clinical judgment. The final decision regarding diagnosis and treatment is the sole responsibility of the professional.
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About this Calculator 💡
The Modified Duke Criteria are the gold-standard tool for the clinical diagnosis of Infective Endocarditis (IE). Developed to standardize the evaluation of patients suspected of having infections in the heart valves or endocardium, the criteria divide findings into 'Major' and 'Minor'. Major criteria include microbiological evidence (such as positive blood cultures for typical pathogens) and imaging evidence (such as vegetations or abscesses detected by echocardiogram). Minor criteria cover predisposing factors (prior heart disease or IV drug use), fever, vascular phenomena (such as arterial embolism), immunological phenomena (such as glomerulonephritis), and microbiological evidence that does not meet major criteria. The diagnosis is classified into three categories: 'Definite', 'Possible', or 'Rejected', depending on the specific combination of findings. This tool is crucial to ensure that intensive antibiotic treatment or surgery is initiated accurately, avoiding both underdiagnosis and unnecessary treatment.
Reference Values
- • Definite Endocarditis
- • Possible Endocarditis
- • Rejected Diagnosis
Formula
The diagnosis is determined by the following clinical combinations: 1) Definite Endocarditis: Requires 2 Major criteria, OR 1 Major + 3 Minor criteria, OR 5 Minor criteria. 2) Possible Endocarditis: Requires 1 Major + 1 Minor criteria, OR 3 Minor criteria. 3) Rejected Diagnosis: Does not meet the criteria for 'Definite' or 'Possible', has an alternative diagnosis, or symptoms resolve within 4 days of antibiotic therapy.
Reference
Li JS, et al. Clin Infect Dis. 2000.