Diagnostic Criteria | Medibuddy
24th June 2026

Diagnostic Criteria

The diagnosis of IE is made based on the modified Duke’s criteria, outlined in the table below. A definite diagnosis of IE is defined as the presence of: two major criteria; one major and three minor criteria; or five minor criteria. A possible diagnosis is defined as: one major and one minor criterion or; three minor criteria. These are summarised in table 2:

Major criteria Positive blood culture: typical microorganism associated with IE from two separate blood cultures (staph aureus, viridans streptococci, strep bovis, HACEK, community-acquired enterococci)
Evidence of endocardial involvement:
Echo positive for IE
New valvular regurgitation
Minor criteria Predisposition (e.g. IVDU, predisposing heart condition)
Fever >38 C
Vascular phenomena (septic emboli, mycotic aneurysm, Janeway lesions, septic infarcts, intracranial haemorrhage)
Immunologic phenomena (glomerulonephritis, Osler’s nodes, Roth spots)
Microbiologic evidence (positive blood cultures that do not meet major criteria OR serologic evidence of active infection with organism consistent with IE)

Table 2: modified Duke criteria for infective endocarditis

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