AN EVALUATION OF THE DUKE CRITERIA IN 25 PATHOLOGICALLY CONFIRMED CASES OF PROSTHETIC VALVE ENDOCARDITIS

Six studies have compared the sensitivity of the Duke criteria with th at of the Beth Israel criteria for the diagnosis of infective endocard itis without attempting to distinguish between native valve and prosth etic valve cases, After reviewing clinical data from 372 cases of susp ected prosthetic valve endocarditis, we selected 25 cases in which pat hological confirmation of prosthetic valve endocarditis was obtained, By using the Duke criteria and then the Beth Israel criteria, we reass igned a diagnostic classification to these 25 cases on the basis of cl inical parameters alone. Using the Duke criteria, we correctly classif ied 19 cases (76%) as definite endocarditis and rejected none, while t he Beth Israel criteria correctly classified six cases as probable end ocarditis (24%) and rejected five cases (20%). Similar to previous inv estigators who examined the diagnostic sensitivity of the Duke criteri a and Beth Israel criteria, we found that the Duke criteria appear mor e sensitive than the Beth Israel criteria in pathologically confirmed cases of prosthetic valve endocarditis.