Emergency Medical Minute8 Mars 2022

Podcast 762: Endocarditis

Contributor: Jared Scott, MD

Educational Pearls:

Variability of organisms in infecting the myocardial valves
Duke Criteria for Infective Endocarditis includes three categories that can be used to definitively diagnose endocarditis

Pathologic Criteria

pathological evidence of infection

Major Clinical Criteria

positive blood cultures
positive echocardiogram findings (TEE is more sensitive than a TTE)

Minor Clinical Criteria (must include all of the below criteria)

Fever
Underlying heart condition or IV drug use
Vascular phenomena (includes Janeway's lesions)
Immunologic phenomena (includes Osler's nodes, Roth spots)
Positive blood cultures or serologic evidence of infection with bacteria known to cause endocarditis

Some studies show up to a 33% one-year mortality of people diagnosed with endocarditis
This criteria was developed by David Durack, MD and he was affiliated with Duke University, shout out to Dr. Pete Bakes!

References

https://www.mdcalc.com/duke-criteria-infective-endocarditis

https://www.youtube.com/watch?v=3NLtNg-pqv0

Holland TL, Baddour LM, Bayer AS, Hoen B, Miro JM, Fowler VG Jr. Infective endocarditis. Nat Rev Dis Primers. 2016;2:16059. Published 2016 Sep 1. doi:10.1038/nrdp.2016.59

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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