Diagnostic criterion for Infective Endocarditis include all, Except:
Answer is C (Raised ESR) Raised ESR is not pa of diagnostic criterion for infective endocarditis. Positive Rheumatoid Factor (immunogenic phenomen) is a minor criteria while positive blood culture and positive echocardiogram are both major criterion for diagnosis of Infective Endocarditis. The Duke Criteria for the Clinical Diagnosis of Infective Endocarditis: Major Criteria 1. Positive blood culture * Typical microorganism for infective endocarditis from two separate blood cultures * Viridans streptococci, Streptococcus gallolyticus, HACEK group, Staphylococcus aureus, or * Community-acquired enterococci in the absence of a primary focus, or * Persistently positive blood culture, defined as recovery of a microorganism consistent with infective endocarditis from: * Blood cultures drawn >12 h apa; or * All of 3 or a majority of 4 separate blood cultures, with first and last drawn at least 1 h apa * Single positive blood culture for Coxiella burnetii or phase I IgG antibody titer of >1:800 2. Evidence of endocardial involvement * Positive echocardiogram" * Oscillating intracardiac mass on valve or suppoing structures or in the path of regurgitant jets or in implanted material, in the absence of an alternative anatomic explanation, or * Abscess, or * New paial dehiscence of prosthetic valve, or * New valvular regurgitation (increase or change in preexisting murmur not sufficient) Minor Criteria 1. Predisposition: predisposing hea condition or injection drug use 2. Fever 38.0degC (100.4degF) 3. Vascular phenomena: major aerial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions 4. Immunologic phenomena: glomerulonephritis, Osler's nodes, Roth's spots, rheumatoid factor 5. Microbiologic evidence: positive blood culture but not meeting major criterion as noted previously' or serologic evidence of active infection with organism consistent with infective endocarditis 'Definite endocarditis is defined by documentation of two major criteria, of one major criterion and three minor criteria, or of five minor criteria. Transesophageal echocardiography is recommended for assessing possible prosthetic valve endocarditis or complicated endocarditis. `Excluding single positive cultures for coagulase-negative staphylococci and diphtheroids, which are common culture contaminants, and organisms that do not cause endocarditis frequently, such as gram-negative bacilli. Note: HACEK, Haemophilus spp., Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella spp.
Positive Echocardiogram
Positive Blood culture
Raised ESR
Positive Rheumatoid Factor