. 2023 Apr 4;12(4):706. doi: 10.3390/antibiotics12040706

Table 1.

Modified Duke criteria (adapted from Habib G. et al. [10]).

Major Criteria	Minor Criteria
Blood cultures positive for IE Typical microorganisms consistent with IE from 2 separate blood cultures: Viridans streptococci, Streptococcus gallolyticus (Streptococcus bovis), HACEK group, Staphylococcus aureus; Community-acquired enterococci, in the absence of a primary focus. Microorganisms consistent with IE from persistently positive blood cultures: Minimum 2 positive blood cultures of blood samples drawn > 12 h apart; All of 3 or a majority of ≥4 separate cultures of blood (with last samples drawn ≥ 1 h apart); Single positive blood culture for Coxiella burnetii or phase I IgG antibody titer > 1:800. Imaging positive for IE Echocardiogram positive for IE: Vegetation; Abscess, pseudoaneurysm, intracardiac fistula; Valvular perforation or aneurysm; New partial dehiscence of prosthetic valve. Abnormal activity around the site of prosthetic valve implantation detected via 18F-FDG PET/CT (only if the prosthesis was implanted for >3 months) or radiolabeled leukocytes SPECT/CT. Definite paravalvular lesions according to cardiac CT.	Predisposing heart condition, or injection drug use. Fever, defined as temperature > 38 °C. Vascular phenomena: major arterial emboli, septic pulmonary infarcts, infectious (mycotic) aneurysm, intracranial hemorrhage, conjunctival hemorrhages and Janeway’s lesions. Immunological phenomena: glomerulonephritis, Osler’s nodes, Roth’s spots and rheumatoid factor. Positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE.

Major Criteria

Minor Criteria

Blood cultures positive for IE
1. Typical microorganisms consistent with IE from 2 separate blood cultures:
  - Viridans streptococci, Streptococcus gallolyticus (Streptococcus bovis), HACEK group, Staphylococcus aureus;
  - Community-acquired enterococci, in the absence of a primary focus.
2. Microorganisms consistent with IE from persistently positive blood cultures:
  - Minimum 2 positive blood cultures of blood samples drawn > 12 h apart;
  - All of 3 or a majority of ≥4 separate cultures of blood (with last samples drawn ≥ 1 h apart);
3. Single positive blood culture for Coxiella burnetii or phase I IgG antibody titer > 1:800.
Imaging positive for IE
1. Echocardiogram positive for IE:
  - Vegetation;
  - Abscess, pseudoaneurysm, intracardiac fistula;
  - Valvular perforation or aneurysm;
  - New partial dehiscence of prosthetic valve.
2. Abnormal activity around the site of prosthetic valve implantation detected via 18F-FDG PET/CT (only if the prosthesis was implanted for >3 months) or radiolabeled leukocytes SPECT/CT.
3. Definite paravalvular lesions according to cardiac CT.

Predisposing heart condition, or injection drug use.
Fever, defined as temperature > 38 °C.
Vascular phenomena: major arterial emboli, septic pulmonary infarcts, infectious (mycotic) aneurysm, intracranial hemorrhage, conjunctival hemorrhages and Janeway’s lesions.
Immunological phenomena: glomerulonephritis, Osler’s nodes, Roth’s spots and rheumatoid factor.
Positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE.