Daniel J Weber, Tobias Deuse
Modified Duke’s Criteria:
- Need 2 major, 1 major + 3 minor, or 5 minor criteria
Major criteria:
- Typical organisms from two separate cultures >12 hrs apart
- Endocardial involvement on Echo
- Single Coxiella culture or IgG positive titer
Minor Criteria:
- IV drug use or predisposing heart condition
- Temp > 38
- Vascular phenomenon
- Immunologic phenomenon
Objectives of Surgical Management:
- Remove infected tissues
- Restore hemodynamics and valvular architecture
- Prevent embolic events
- Open/explore right atrium for those with conduction deficits
- NVE requires at least 6 weeks of post-op antimicrobial therapy
- PVE generally requires at least 8 weeks of antimicrobial therapy
- Complete removal of Pacemaker/Defibrillator system for documented infection of device or leads
- Complete removal of Pacemaker/Defibrillator system reasonable with endocarditis caused by staph aureus or fungi
AI, aortic insufficiency; HACEK, haemophilus, actinobacillus, cardiobacterium, eikenella, kingella; MDR, multi-drug resistant; MR, mitral regurgitation; NVE, native valve endocarditis; PVE, prosthetic valve endocarditis; PVL, paravalvular leak; TEE, transesophageal echocardiography
