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infectious-disease cardiology

Duke Criteria for Infective Endocarditis

Diagnoses infective endocarditis using major and minor Duke criteria. Guides echocardiography, blood culture interpretation, and empirical antibiotic selection.

Score interpretation

IE rejected (0 major, 0-1 minor)

→ IE very unlikely; consider alternative diagnosis; repeat cultures if fever persists; discharge if stable with follow-up

Possible IE (1 major + 1 minor OR 3 minor)

→ Transoesophageal echo (TEE) if TTE negative or prosthetic valve; 3+ blood cultures; cardiology and ID joint review; start empirical antibiotics if clinically unwell (amoxicillin + gentamicin)

Definite IE (2 major OR 1 major + 3 minor OR 5 minor)

→ Definite IE: ID team lead; 6 weeks IV antibiotics (penicillin/vancomycin + gentamicin); cardiac surgery team assessment; early surgery if: HF, uncontrolled infection, abscess, large vegetation; repeat blood cultures daily until negative

Interpretation bands for the Duke Criteria IE. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.