EVALUATION OF THE DUKE CRITERIA VERSUS THE BETH-ISRAEL CRITERIA FOR THE DIAGNOSIS OF INFECTIVE ENDOCARDITIS

New diagnostic criteria for infective endocarditis (IE) have been prop osed by the Duke University Endocarditis Service (Durham, NC) to updat e the widely used Beth Israel (Boston) criteria. We compared the Duke criteria with the Beth Israel criteria in a series of 115 consecutive patients with suspected IE who were hospitalized in a referral center. The diagnosis of IE was histologically and/or bacteriologically confi rmed for 27 operated patients. If surgery had not been performed on th ese 27 patients, 22 vs. 12 would have been classified as having ''clin ically definite'' and ''probable'' IE by the Duke vs, the Beth Israel criteria, respectively, whereas 0 vs, 5 would have been ''rejected'' b y the Duke vs. the Beth Israel criteria, respectively. The improvement in sensitivity of the criteria from 44% (Beth Israel) to 82% (Duke) w as statistically significant (P < .01). We confirm that the Duke crite ria improve the sensitivity of diagnosis of IE. The specificity of the se criteria should be further evaluated.