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ESC 2023 Modified Duke Criteria Calculator

  • Major Criteria
    Positive blood cultures for typical microorganisms
    Evidence of endocardial involvement on echocardiography (TEE or TTE)
    PET/CT or MRI positive for endocarditis
  • Minor Criteria
    Predisposing heart condition or IV drug use
    Fever >38°C
    Vascular phenomena (major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions)
    Immunological phenomena (glomerulonephritis, Osler nodes, Roth spots, rheumatoid factor)
    Microbiological evidence not meeting major criterion
  • ESC 2023 Modified Duke Criteria (with PET/CT and MRI): Explanation and Clinical Context
    The ESC 2023 Modified Duke Criteria integrate clinical, microbiological, and imaging findings to diagnose infective endocarditis (IE) with improved accuracy.
    Major criteria include positive blood cultures for typical microorganisms, evidence of endocardial involvement on echocardiography, and modern imaging modalities such as PET/CT and MRI showing signs of endocarditis.
    Minor criteria encompass predisposing conditions (heart disease or IV drug use), fever, vascular phenomena, immunological phenomena, and microbiological evidence not fulfilling major criteria.
    Diagnosis is classified as Definite, Possible, or Rejected IE based on the combination of major and minor criteria. The inclusion of PET/CT and MRI enhances sensitivity, particularly for prosthetic valve endocarditis and cardiac device-related infections.
    This tool aids clinicians in risk stratification, guiding therapy decisions, and planning follow-up strategies.

    Reference:
    Habib G, Lancellotti P, Antunes MJ, et al. 2023 ESC Guidelines for the management of infective endocarditis. Eur Heart J. 2023;44:3717–3825. doi:10.1093/eurheartj/ehad380

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