Major criteria

1) Blood culture positive for IE

a) Typical microorganisms consistent with IE from 2 separate blood culture

● Viridans streptococci, Streptococcus bovis, HACEK group, Stapylococcus aureus; or

● Community-acquired enterococci, in the absence of a primary focus; or

b) Microorganism consistent with IE from persistently positive blood cultures, defined as follows:

● At least 2 positive cultures of blood samples drawn > 12 h apart; or

● All of 3 or a majority of ≥4 separate cultures of blood (with first and last sample drawn at least 1h apart)

c) Single positive blood culture for Coxiella burnetii or antiphase I Ig G antibody titer > 1 > 800

2) Evidence of endocardial involvement

a) Echocardiogram positive for IE (TTE recommended in patient with prosthetic valves; rated at least “possible” IE by clinical criteria or complicated IE (paravalvular abcess); TTE as first test in other patients), defined as follows:

● Oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets, or on implanted material in the absence of an alternative anatomic explanation; or

● Abcess; or

● New partial dehiscence of prosthetic valve

b) New valvular regurgitation (worsening or changing of pre-existing murmur not sufficient