Pathological criteria
| |
Microorganisms demonstrated by culture or histological examination | |
Active endocarditis demonstrated by histological examination | |
Major criteria
| |
Positive blood cultures | To be added: |
| Typical microorganisms consistent with endocarditis from two separate blood cultures | | Positive serology for Coxiella burnetti |
Bacteraemia due to Staphylococcus aureus |
Positive molecular assay for specific gene targets and universal loci for bacteria and fungi |
| Microorganisms consistent with endocarditis from persistently positive blood cultures | |
Positive serology for Chlamydia psittaci |
Evidence of endocardial involvement | | Positive serology for Bartonella species |
| Echocardiography: oscillating structures, abscess formation, new partial dehiscence of prosthetic valve | | |
| New valvar regurgitation | |
Minor criteria
| | |
| Predisposing heart disease | To be omitted: |
| Fever >38°C | | Suspect echocardiography (no major criterion) |
Vascular phenomena |
| Immunological phenomena | To be added: |
| Microbiological evidence (no major criterion) | | Elevated CRP, elevated ESR, splenomegaly, haematuria, clubbing, splinter haemorrhages, petechiae and purpura |
| Suspect echocardiography (no major criterion) |
| Identified IE organism from metastatic lesions |
Categories
| |
Definite: | Pathological criteria positive | |
| or 2 major criteria positive | |
| or 1 major and 2 minor criteria positive | |
| or 5 minor criteria positive | |
Possible: | All cases which cannot be classified as definite or rejected | | 1 major and 1 minor criterion positive |
| 3 minor criteria positive |
Rejected: | Alternative diagnosis | | |
| Resolution of the infection with antibiotic treatment for ⩽4 days | | |
| No histological evidence | | |