How to Remember Dukes Criteria for Infective Endocarditis : Mnemonic

Mnemonic: Bacterial Endocarditis FIVE PM




Major Criteria

B : Blood culture +ve
  1. Typical micro-organisms in 2 seperate cultures or
  2. Persistently +ve blood cultures drawn 12 hours apart or
  3. Single +ve blood culture for Coxiella burnetti
E : Endocardial involvement
  1. +ve echocardiogram (vegetation, abscess or valve dehiscence) or
  2. New valvular regurgitation
Minor criteria
  1. Fever > 38 oC 
  2. Immunologic phenomena (glomerulonephritis, Osler’s nodes, Roth’s spots, Rheumatoid factor)
  3. Vascular phenomena (major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjuntival hemorrhage, Janeway lesions)
  4. Echocardiography findings (suggestive but not definitive)
  5. Predisposition (heart condition or IV drug user) 
  6. Microbiologic evidence (Positive blood culture but not meeting major criteria)

Definitive Diagnosis requires 2 Major  or 3 Minor + 1 Major or  5 Minor 


Proposed Modication of Dukes Criteria

4 comments :

  1. Echocardiography is no longer a minor criterion.

    ReplyDelete
  2. BE JOAN OF ARC
    Major criteria
    B-blood culture positive
    E- echo evidence of vegetation and valvular regurgitation

    Minor criteria
    J- janeway lesion
    O- oslers node
    A- aneurysm(mycotic); abuse(idu)
    N- nephritis
    O- other predisposing heart condition
    F-fever
    A- arterial emboli
    R-roth's spot; rheumatoid factor
    C- culture positive not meeting major criteria

    ReplyDelete
  3. BE JOAN OF ARC
    Major criteria
    B-blood culture positive
    E- echo evidence of vegetation and valvular regurgitation

    Minor criteria
    J- janeway lesion
    O- oslers node
    A- aneurysm(mycotic); abuse(idu)
    N- nephritis
    O- other predisposing heart condition
    F-fever
    A- arterial emboli
    R-roth's spot; rheumatoid factor
    C- culture positive not meeting major criteria

    ReplyDelete

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