Adapted from Durack DT, et al,2 and Li JS, et al.4 Table 25. Major and Minor Criteria in the Modified Duke Criteria for the Diagnosis of IE Major criteria Blood culture positive for IE Typical microorganisms consistent with IE from 2 separate blood cultures: Viridans streptococci, Streptococcus bovis, HACEK group (Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella spp, and Kingella kingae), S. aureus; or community-acquired enterococci, in the absence of a primary focus; or Microorganisms consistent with IE from persistently positive blood culture results, defined as follows: At least 2 positive culture results of blood samples drawn 12 h apart; or All of 3 or most of 4 separate culture samples of blood (with first and last samples drawn at least 1 h apart) Single positive blood culture result for Coxiella burnetii or antiphase I IgG antibody titer >1:800 Evidence of endocardial involvement Echocardiogram positive for IE defined as follows: Oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation Abscess; or New partial dehiscence of prosthetic valve New valvular regurgitation (worsening or changing of preexisting murmur not sufficient) Minor criteria Predisposition, predisposing heart condition, or injection drug use Vascular phenomena, major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and Janeway lesions Immunological phenomena: glomerulonephritis, Osler s nodes, Roth s spots, and rheumatoid factor Microbiological evidence: positive blood culture but does not meet a major criterion as noted above* or serological evidence of active infection with organism consistent with IE *Excludes single positive cultures for coagulase-negative staphylococci and organisms that do not cause IE. IE indicates infective endocarditis; IgG, immunoglobulin G; and spp, species. 