Definitions of Modified Dukes Criteria Major Criteria

Blood culture positive for IE:

Typical microorganisms consistent with IE from two separate blood cultures:

Viridans streptococci, S. bovis, HACEK group, S. aureus, or community-acquired en-terococci in the absence of a primary focus, or Microorganisms consistent with IE from persistently positive blood cultures, defined as follows:

At least two positive cultures of blood samples drawn greater than 12 hours apart, or All of three or a majority of four separate cultures of blood (with first and last sample drawn at least 1 hour apart)

Single positive blood culture for C. burnetii or antiphase I IgG antibody titer greater than 1:800

Evidence of endocardial involvement:

Echocardiogram positive for IE (TEE recommended in patients with prosthetic valves, rated at least "possible IE" by clinical criteria, or complicated IE [paravalvular abscess] TTE as first test in other patients), defined as follows:

Oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant, or on implanted material in the absence of an alternative anatomic explanation, or

Abscess, or

New partial dehiscence of prosthetic valve

New valvular regurgitation (worsening or changing of pre-existing murmur not sufficient)

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