Major criteria

Two positive blood cultures for organisms typical of endocarditis drawn > 12 hours apart

All of 3 or a majority of 4 or more positive blood cultures (with at least 1 hour between first and last culture) for organisms consistent with endocarditis

Serologic evidence of Coxiella burnetii (IgG titer > 1:800) or one positive blood culture for Coxiella burnetii

Echocardiographic evidence of endocardial involvement:

• Oscillating intracardiac mass on a heart valve, on supporting structures, in the path of regurgitant jets, or on implanted material without another anatomic explanation

• Cardiac abscess

• New partial dehiscence of prosthetic valve

• New valvular regurgitation

Minor criteria

Predisposition, predisposing heart disorder, or IV illicit drug use

Fever ≥ 38.0° C (≥ 100.4°F)

Vascular phenomena:

• Arterial embolism

• Septic pulmonary embolism

• Mycotic aneurysm

• Intracranial hemorrhage

• Conjunctival petechiae

• Janeway lesions

Immunologic phenomena:

• Glomerulonephritis

• Osler nodes

• Roth spots

• Rheumatoid factor

Microbiologic evidence of infection consistent with but not meeting major criteria

Serologic evidence of infection with organisms consistent with endocarditis