CLASSIFICATION OF INFECTIVE ENDOCARDITIS BY DUKES CRITERIA AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY - A 1-YEAR RETROSPECTIVE ANALYSIS

A sensitive, specific, and rapid diagnosis of infective endocarditis ( IE) is important for prognosis, and to exclude IE and thus avoid prolo nged treatment with antibiotics. The diagnostic system for IE accordin g to Duke's university includes echocardiographic results and classifi es patients in 3 categories - 'definite', 'possible', and 'rejected' - by combining pathologic, echocardiographic, clinical, and blood cultu re findings. Transesophageal echocardiography (TEE) has better diagnos tic sensitivity compared to transthoracic echocardiography. Duke's cri teria were used on 83 patients examined by TEE in a retrospective stud y. Of 83 patients sith suspected IE, 49 episodes in 48 patients were c lassified as 'rejected' and were not treated. The remaining 37 patient s (15 of whom were intravenous drug users) were treated and classified as follows: 'definite', 26 episodes in 24 patients, 'possible', 11 ep isodes in 11 patients; and 'rejected', 2 episodes in 2 patients. In th is retrospective analysis Duke's criteria were easy to apply. A negati ve TEE made IE unlikely and a positive TEE made IE probable when other signs of infection were present.