2023 Duke-ISCVID Criteria for Infective Endocarditis

Pathogen: Pathogens identified in tissue or implanted material with clinical features of IE. Pathological Histological: Characteristic histological features of active IE. Pathological

Micro: Typical pathogens from ≥ 2 separate blood culture sets. Major Micro: Nontypical pathogens from ≥ 3 separate blood culture sets. Major Micro: C. burnetii in single blood culture and/or another study (e.g., PCR, anti-phase 1 IgG titer). Major Micro: Bartonella spp. or T. whipplei on blood molecular testing (e.g., PCR). Major Micro: IgM/IgG antibodies to Bartonella henselae/quintana on IFA (IgG titer ≥ 1:800). Major Imaging: Characteristic IE findings on Echocardiogram and/or Cardiac CT scan (e.g., new valvular regurgitation). Major Imaging: ¹⁸F-FDG PET/CT scan with findings suggestive of IE. Major Surgical: Surgical evidence of IE on direct tissue inspection during cardiac surgery. Major

Predisposition: Heart abnormality, IDU, history of IE, and/or a CIED. Minor Fever: Temperature > 38°C (100.4°F). Minor Vascular: Vascular phenomena (emboli, mycotic aneurysm, Janeway lesions, etc.). Minor Immunologic: Immunologic phenomena (Osler nodes, Roth spots, glomerulonephritis). Minor Micro: Positive blood cultures that do not fulfill major criteria. Minor Micro: Positive culture/molecular test from noncardiac sterile site OR positive PCR for skin pathogen on valve/wire. Minor Imaging: Abnormal ¹⁸F-FDG PET/CT within 3 months of prosthetic implantation/graft (with valve involvement). Minor Auscultation: New valvular regurgitation on auscultation (if echocardiography is unavailable). Minor