Diagnosis, prophylaxis and treatment


Diagnosis is based on anamnesis, cinical examination and modified Dukes criteria.

Diagnosis of endocarditis is accepted if there are:

  • 1 anatomo-pathological criteria or
  • 2 majors critersia or
  • 1 major criteria majeur and 2 minors criteria or
  • 5 minors criteria

Modified Dukes criteria:

Antomo-pathological criteria:

  • Positive histology or positive microbiology on anatomo-pathological material obtained on autopsy or during cardiac surgery (valves, vegetations, peripheral emboli or intracardial abcess).

Majors criteria:

  • Twice positive hemocultures for bacteria compatibles with endocarditis: Streptococcus viridans or those from the HACEK group or:
  • Persistant bacteremia on 2 hemocultures at 12 hours interval or positive hemocultures or 2 or more samples for less common bacteria like: Staphylococcus aureus, Staphylococcus epidermidis or
  • Positive serology for Coxiella Brunetti, Bartonella, Chlamydia psitacci or
  • Positive molecular tests for specific target genes or -Positive echocardiography showing mobiles structures, abcesses new regurgitation or prosthesis dehiscence.

Minor criteria:

  • Underlying cardiopathy as a risk factor
  • Fever > 38 ° C
  • Immunological disorder like glomerulonephriise, Rendu-Osler nodules, rhumatoid factor or Roth spots
  • Microbiological abnormalities not included in the major criteria group
  • Augmented CRP or Sedimentation rate
  • Vascular abnormalities like: peripheral emboli, splenomegalia, purpura, petechiae, clubbing.