II. Criteria: Endocardititis causative organisms (used in criteria below)
- Viridans Streptococcus
- Streptococcus bovis
- Staphylococcus aureus
- Community-acquired enterococci without findings of primary focus
-
Gram negative HACEK Bacilli
- Haemophilus species
- Aggregatibacter actinomycetemcomitans
- Cardiobacterium hominis
- Eikenella corrodens
- Kingella kingae
III. Criteria: Major
- Positive Blood Culture
- Two separate Blood Cultures positive for causative organisms or
- Two Blood Cultures drawn >12 hours apart demonstrate causative organism or
- Blood Cultures drawn with at least 3/3 or 3/4 positive for causative organism with >1 hour between first and last blood draw or
- Single Blood Culture positive for Coxiella Burnetii or
- Phase 1 Immunoglobulin GAntibody titer >1:800
- Endocardial involvement
- New valvular regurgitation (beyond simply a change in pre-existing murmur) or
- Positive Echocardiogram
- Intracardiac abscess or
- New partial dehiscence of prosthetic valve or
- Oscillating intracardiac mass without an alternative anatomic explanation
- On valve
- On supporting structures
- In path of regugitant jets
- On implanted material
IV. Criteria: Minor
- Fever (>38 C or 100.4 F)
- Predisposing condition
- Immunologic findings
- Microbiologic findings
- Positive Blood Culture that does not meet major criteria
- Serologic evidence of active infection with endocarditis causative organism (see above list)
- Vascular findings
- Major arterial emboli
- Septic Pulmonary Infarctions
- Mycotic aneurysm
- Intracranial Hemorrhage
- Conjunctival Hemorrhage
- Janeway Lesion
V. Interpretation: Endocarditis Diagnosis
- Definitive Endocarditis Diagnosis
- Pathology specimens (microorganisms, vegetations, intracardiac abscess) from surgery or autopsy OR
- Clinical Criteria (one of the following)
- Two major criteria or
- One major criteria and three minor criteria or
- Five minor criteria
- Possible Endocarditis Diagnosis
- One major criteria and 1-2 minor criteria OR
- Three minor criteria
- Rejected Diagnosis (findings NOT consistent with Infective Endocarditis)
- Firm alternative diagnosis is established instead of Infectious Endocarditis OR
- Resolution of findings with <=4 days of antibiotic therapy OR
- No evidence of Infective Endocarditis at surgery or autopsy and <=4 days of antibiotic therapy OR
- Does not meet definitive or possible Endocarditis Diagnosis criteria (see above)
