The value of the Von Reyn and the Duke diagnostic criteria for infective endocarditis in internal medicine practice. A study of 38 cases

Abstract

Background: The aim of our study was to compare the value of the Von Reyn and the Duke diagnostic criteria for infective endocarditis (IE) in internal medicine practice. Methods: We determined the sensitivity and negative predictive value of these two sets of diagnostic criteria in 38 patients with established infective endocarditis who were followed in two departments of general internal medicine. The patients essentially had subacute endocarditis of the aortic valve (79%) with several systemic manifestations (100%). Microbial documentation included mainly gram-positive cocci (60%). Results: With transthoracic echocardiography (TTE), the sensitivities of the Duke and the Von Reyn criteria were 65% and 35%, respectively, while with transesophageal echocardiography (TEE), these sensitivities were 75% and 35%, respectively. With TTE and TEE, the negative predictive values were 100% for the Duke diagnostic criteria versus only 71% for the Von Reyn criteria. Conclusions: This study confirms that the Duke diagnostic criteria are useful in practice for the management of patients with infective endocarditis followed in internal medicine.