Your activity: 4 p.v.

Calculator: Clinical diagnosis of endocarditis* (not appropriate for neonates [age ≤28 days])

Calculator: Clinical diagnosis of endocarditis* (not appropriate for neonates [age ≤28 days])


Diagnostic: 2 major clinical criteria and 0 minor clinical criteria

Diagnostic: 1 major clinical criteria and 3 minor clinical criteria

Diagnostic: 0 major clinical criteria and 5 minor clinical criteria

Major clinical diagnostic criteria
      Positive blood cultures
  • For organisms that are typical causes of IE: 2 positive cultures from samples drawn >12 hours apart; or
  • For organisms that are more commonly skin contaminants: 3 or a majority of ≥4 separate blood cultures (first and last sample drawn at least 1 hour apart).
      Echocardiogram with (1 or more of the following):
  • Vegetation (oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation)
  • Abscess
  • New partial dehiscence of prosthetic valve
  • New valvular regurgitation
      Single positive blood culture for Coxiella burnetii or anti-phase 1 IgG antibody titer >1:800

Minor clinical diagnostic criteria
      Intravenous drug use or predisposing heart condition (prosthetic heart valve or a valve lesion associated with significant regurgitation or turbulence of blood flow)
      Fever: Temperature >38.0°C (100.4°F)
      Vascular phenomena (1 or more of the following):
  • Major arterial emboli
  • Septic pulmonary infarcts
  • Mycotic aneurysm
  • Intracranial hemorrhage
  • Conjunctival hemorrhages
  • Janeway lesions
      Immunologic phenomena (1 or more of the following):
  • Glomerulonephritis
  • Osler nodes
  • Roth spots
  • Rheumatoid factor
      Microbiological evidence: Positive blood culture that does not meet major criteria as noted above OR serological evidence of active infection with organism consistent with endocarditis



  • *IE can also be diagnosed by separate pathologic criteria, which are not included in the clinical criteria.
  • ¶Typical IE organisms are:
    • Staphylococcus aureus
    • Viridans streptococci
    • Streptococcus gallolyticus (formerly S. bovis), including nutritional variant strains (Granulicatella spp and Abiotrophia defectiva)
    • HACEK group:
      • Haemophilus aphrophilus (subsequently called Aggregatibacter aphrophilus and Aggregatibacter paraphrophilus)
      • Actinobacillus actinomycetemcomitans (subsequently called Aggregatibacter actinomycetemcomitans)
      • Cardiobacterium hominis
      • Eikenella corrodens
      • Kingella kingae
    • Community-acquired enterococci, in the absence of a primary focus
  • IgG: immunoglobulin; IE: infective endocarditis.

Only digits 0 to 9 and a single decimal point (".") are acceptable as numeric inputs. Attempted input of other characters into a numeric field may lead to an incorrect result.

Information on this page may not appear correctly if printed.

Legal Notices and Disclaimer

All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Click here for full notice and disclaimer.

EBMcalc is Copyright © 1998-2023 Foundation Internet Services, LLC

Topic 13487 Version 18.0