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

Notes

*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.

References

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Topic 13487 Version 18.0