Case challenge · Infectious disease / Cardiology · teaching

Infective Endocarditis — Diagnostic Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

← View the full flowchartBased on 2023 Duke-ISCVID

Case #1Infectious disease / Cardiology

📋 Case data

Modified Duke determinationRejected

Data is taken from this pathway's reviewed node text. Work through the pathway step by step.

Step 1 / 1 · Modified Duke determination

Modified Duke (2023 ISCVID) diagnostic category?

💡 Major criteria: 1) microbiology — typical organisms in ≥2 positive blood culture sets (Staph aureus, viridans strep, Strep bovis, HACEK, community-acquired enterococci, etc.) or persistently positive / Coxiella; 2) imaging — echo (TTE → TEE more sensitive) or cardiac CT showing vegetation/abscess/perivalvular pseudoaneurysm/fistula/valve perforation/prosthetic dehiscence, or new valvular regurgitation, or abnormal PET/CT uptake; 3) (new) direct intraoperative evidence. Minor criteria: predisposing factor (heart disease/IV drug use/prosthetic valve/CIED/prior IE), fever ≥38°C, vascular signs, immunologic signs, microbiologic evidence not meeting major.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.