Diagnostic Criteria for Infective Endocarditis

Abstract

Diagnosis of infective endocarditis usually relies on the association of an infectious syndrome and a recent endocardial involvement. This association is the cornerstone of the successive diagnostic criteria proposed to facilitate the difficult diagnosis of the disease. During the past decades these classifications have been modified with the progress of the microbiological testing and the cardiac imaging techniques. Recently, the 2015 Guidelines of European Society of Cardiology have proposed new diagnostic criteria, which implemented new imaging modalities for improving diagnostic yield. The identification of paravalvular lesions by cardiac computed tomography and, the in the setting of suspicion of endocarditis on a prosthetic valve, an abnormal activity around the site of implantation detected by ¹⁸F-FDG PET/CT or radiolabelled leukocytes SPECT/CT are now considered as a major criterion. Moreover, the identification of recent embolic events or infectious aneurysms only by imaging (silent events) is now considered as a minor criterion.