Endocarditis may affect:
(1) a natural (native) valve
(2) a prosthetic valve
The presence of one or both of the following can be used to diagnose endocarditis
(1) micro-organisms cultured from valve tissue or vegetation
(2) all of the following:
(2a) 2 or more of the following:
(2a1) fever (> 38°C, rectal if <= 1 years)
(2a2) hypothermia if <= 1 year (rectal temperature < 37°C)
(2a3) apnea if <= 1 year of age
(2a4) bradycardia if <= 1 year of age
(2a5) new or changing murmur
(2a6) embolic phenomena
(2a7) petechiae, splinter hemorrhages, painful subcutaneous nodules or other skin changes
(2a8) congestive heart failure
(2a9) cardiac conduction abnormality
(2b) one or more of the following:
(2b1) same microorganisms cultured from 2 or more blood cultures
(2b2) organisms seen in Gram stain of valve when culture negative or not done
(2b3) valvular vegetation seen during a surgical operation or autopsy
(2b4) positive antigen test using serum or urine
(2b5) evidence of new vegetation seen on echocardiogram
(2c) no other explanation
(2d) The physician started appropriate antibiotic therapy if the diagnosis was made antemortem.
where:
• The presence of a new vegetation seen on echocardiogram can be seen with sterile vegetations.
