Duke Criteria

Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Modified the 1994 Durack criteria: added S. aureus bacteraemia and Q fever as major criteria, removed "echocardiogram non-diagnostic" as a minor criterion, and clarified the "possible" category.

Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. The original Duke criteria on which this classification is based.

The 2023 Duke-ISCVID criteria (Fowler VG et al., Clin Infect Dis 2023; PMID 37138445) update the microbiological, imaging (cardiac CT, PET-CT) and surgical criteria and are increasingly the reference standard. All versions are classification — not clinical diagnostic — criteria; a "possible" or "rejected" result does not exclude endocarditis when clinical suspicion is high. This tool covers the clinical pathway only; pathological criteria and firm alternative diagnoses are assessed separately.