Diagnostic criterion for infective endocarditis includes all EXCEPT:
Correct Answer: ESR
Description: ESR REF: Harrison's 17th ed Chapter 118 The duke's criteria for Infective endocarditis Major Criteria 1. Positive blood culture Typical microorganism for infective endocarditis from two separate blood cultures Viridans streptococci, Streptococcus bovis, 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 three or a majority of four or more separate blood cultures, with first and last drawn at least 1 h apa Single positive blood culture for Coxiella burnetii or phase 1 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 Predisposition: predisposing hea condition or injection drug use Fever 38.0degC (100.4degF) 3. Vascular phenomena: major aerial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, Janeway lesions Immunologic phenomena: glomerulonephritis, Osler's nodes, Roth's spots, rheumatoid L factor 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
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