At Duke University, clinical criteria for the diagnosis of infective endocarditis (IE) were drafted in 1994 and referred to as the "Duke criteria" (Erdmann 2006). Since then, these criteria have been modified several times (Herold 2022).
At Duke University, clinical criteria for the diagnosis of infective endocarditis (IE) were drafted in 1994 and referred to as the "Duke criteria" (Erdmann 2006). Since then, these criteria have been modified several times (Herold 2022).
The modified Duke criteria represent a highly sensitive and specific diagnostic procedure for infective endocarditis (IE) (Kasper 2015). In addition, the Duke criteria can exclude the most important differential diagnoses of IE (Knirsch 2022).
The criteria are based on clinical, laboratory chemistry, imaging findings, and major or minor criteria (Knirsch 2022).
Sensitivity and specificity are around 80%. Subsequent modifications have resulted in a sensitivity for pediatric patients of nearly 90% (Knirsch 2022). For prosthetic valve endocarditis, the sensitivity is also 90% (Saha 2022).
The modified Duke criteria are defined as follows:
Main criteria are:
1. blood culture positive for IE:
2. positive imaging for IE:
Secondary criteria are:
The diagnosis is considered confirmed in the presence of:
or
or
or
Pathologic criteria for the definite presence of an IE are met such as:
or
or
There is a suspected diagnosis of:
or
If the Duke criteria are not met, IE cannot be ruled out. This is only the case if (Girndt 2022):
or
or
or
If only a possible but not definite IE is present when using the modified Duke criteria, repeated testing of the Duke criteria and, if necessary, supplementary diagnostics are recommended (Knirsch 2022).