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Diagnosis - Minor criteria are 1 Predisposition heart...

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Diagnosis The diagnosis of IE is suggested by persistently positive blood cultures. In the absence of positive blood cultures, clinical signs and symptoms and a high index of suspicion will often lead to the diagnosis. The advent of echocardiography allowed for the development of diagnostic criteria to aid in determining definite or possible IE. The Duke Diagnostic Criteria utilizes microbiological, clinical, echocardiographic and pathologic factors to predict the likelihood of IE. Major criteria are: 1. Positive blood cultures of typical microorganisms that cause IE or persistently positive blood cultures without another source o At least 95% of patients with IE have positive blood cultures o Cultures should be obtained before antibiotics are given 2. Evidence of endocardial involvement o echocardiography: vegetation, abscess or new partial dehiscence of prosthetic valve seen on echocardiography o clinical: new insufficiency (regurgitation) murmur
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Unformatted text preview: Minor criteria are: 1. Predisposition: heart condition, valvular abnormality or IVDU 2. Clinical symptoms – unexplained fever and other constitutional symptoms 3. Vascular and/or embolic phenomena 4. Immunologic phenomena (glomerulonephritis, Osler’s nodes, Roth spots) 5. Microbiologic evidence not meeting major criteria 6. Echocardiographic evidence not meeting major criteria A definite case of IE has 1. Pathologic evidence o Microorganisms by culture or histology from a vegetation or embolus o Vegetation or intracardiac abscess confirmed by histology OR 2. Clinical criteria o 2 major criteria o 1 major and 3 minor criteria o 5 minor criteria Do NOT memorize this definition of definite IE, but be aware of the Duke Classification Criteria and the components involved in establishing a diagnosis, i.e., clinical events, microbiology, pathology and echocardiography....
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