Raoult reported criteria for the diagnosis of Q fever endocarditis. The author is for Aix Marseille Universite.
Definitive criteria:
(1) positive culture of a cardiac valve
(2) positive PCR of a cardiac valve
(3) positive immunohistochemistry of a cardiac valve
Major criteria:
(1) microbiology evidence: positive culture of blood or embolus; positive PCR of blood or embolus; anti phase I IgG antibody titer >= 6400
(2) evidence of endocardial involvement (see below)
Evidence of endocardial involvement:
(1) echocardiographic positive for infective endocarditis
(1a) oscillating intra-cardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation
(1b) abscess
(1c) new partial dehiscence of prosthetic valve
(1d) new valvular regurgitation (not sufficient if worsening or changing of a pre-existing murmur)
(2) PET scan showing specific valve fixation and mycotic aneurysm
Minor criteria:
(1) predisposing heart condition
(2) fever (temperature > 38°C)
(3) vascular phenomena: major arterial emboli; septic pulmonary infarcts; mycotic aneurysm; intracranial hemorrhage; conjuncitval hemorrhages; Janeway's lesions
(4) immunologic phenomena: glomerulonephritis, Osler's nodes, Roth spots, rheumatoid factor
(5) anti phase I IgG antibody titer >= 800 and < 6400
|
Definitive
|
Major
|
Minor
|
Interpretation
|
|
>= 1
|
NA
|
NA
|
definite
|
|
0
|
2
|
NA
|
definite
|
|
0
|
1 (microbiology)
|
>= 3 (including predisposing heart)
|
definite
|
|
0
|
1 (microbiology)
|
2 (including predisposing heart)
|
possible
|
|
0
|
0
|
>= 3 (including predisposing heart and serology)
|
possible
|
