Major criteria

Positive blood cultures
Typical organism isolated from two separate blood cultures:

• Streptococcus viridans species or Streptococcus gallolyticus
• HACEK group organisms
• Staphylococcus aureus
• Community-acquired enterococci in the absence of another focus

Persistently positive blood cultures (from organism not mentioned above).

• Two blood cultures positive, drawn 12 hours apart
• Three of four blood cultures positive, even if drawn together

Evidence of endocardial involvement
Echocardiographic evidence of endocarditis:

• Vegetation defined as “oscillating intracardiac mass on a valve or supporting structure, in the path of a regurgitant jet, or on implanted material”
• Intracardiac abscess
• Dehiscence of a prosthetic heart valve

New valvular regurgitation (new murmur does not meet criteria).

Minor criteria

Predisposing heart condition or IV drug use

Fever (38.0 C or 100.4 F)

Vascular phenomena

• Arterial embolism
• Septic pulmonary infarctions
• Mycotic aneurysm
• Intracranial hemorrhage or conjunctival hemorrhages
• Janeway lesions

Immunologic phenomena

• Glomerulonephritis
• Osler’s nodes
• Roth spots
• Positive rheumatoid factor

Microbiologic evidence (positive blood cultures not meeting major criteria)