Duke Criteria for Endocarditis

The Duke criteria are used to rule in or rule out endocarditis.

Endocarditis is felt to be present in the following conditions:

• Direct evidence of endocarditis based upon histological findings (a pathological criterion)
• Positive Gram stain results or cultures of specimens obtained from surgery or autopsy (a pathological criterion)
• 2 major clinical criteria
• 1 major and any 3 minor clinical criteria
• 5 minor clinical criteria

'Possible endocarditis' is defined by 1 major and 1 or 2 minor clinical criteria, OR 3 minor clinical criteria

The diagnosis of endocarditis is 'rejected' in any of the following cases:

• a firm alternate diagnosis is made
• clinical manifestations resolve after ≤4 days of antibiotic therapy
• no pathological evidence of infective endocarditis is found at surgery or autopsy after antibiotic therapy for ≤4 days
• fail to meet criteria for for possible or definite infective endocarditis