Table 4. Definitions of the Terms Used in the European Society of Cardiology 2015 Modified Criteria for the Diagnosis of Infective Endocarditis[3,65].

Major criteria
1. Blood cultures positive for IE  a. Typical microorganisms consistent with IE from two separate blood cultures: • Viridans streptococci, Streptococcus gallolyticus (Streptococcus bovis), HACEK group, Staphylococcus aureus; or • Community-acquired enterococci, in the absence of a primary focus; or  b. Microorganisms consistent with IE from persistently positive blood cultures: • ≥2 positive blood cultures of blood samples drawn >12 h apart; or • All of 3 or a majority of ≥4 separate cultures of blood (with first and last samples drawn ≥1 h apart); or  c. Single positive blood culture for Coxiella burnetii or phase I IgG antibody titre >1:800  2. Imaging positive for IE  a. Echocardiogram positive for IE:*  •   Vegetation; •   Abscess, pseudoaneurysm, intracardiac fistula; •   Valvular perforation or aneurysm; •   New partial dehiscence of prosthetic valve. b. Abnormal activity around the site of prosthetic valve implantation detected by 18F-FDG PET/CT (only if the prosthesis was implanted for >3 months) or radiolabelled leukocytes SPECT/CT. c. Definite paravalvular lesions by cardiac CT.
Minor criteria
1. Predisposition such as predisposing heart condition, or injection drug use. 2. Fever defined as temperature >38°C. 3. Vascular phenomena (including those detected by imaging only): major arterial emboli, septic pulmonary infarcts, infectious (mycotic) aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway’s lesions. 4. Immunological phenomena: glomerulonephritis, Osler’s nodes, Roth’s spots, and rheumatoid factor. 5. Microbiological evidence: positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE.
* Although it is was not included in the ESC 2015 Modified Duke Criteria, “new valvular regurgitation (Worsening or changing or pre-existing murmur not sufficient)” was included as a major echocardiographic criterion in the original Modified Duke Criteria (3).