The Duke criteria for diagnosis of infective endocarditis require 2 major, 1 major + 3 minor, or 5 minor criteria. Which of the following correctly represents a MAJOR criterion?

• A Fever > 38°C
• B Vascular phenomena (Janeway lesions, septic arterial emboli)
• C Two separate blood cultures positive for Staphylococcus aureus ✓
• D Predisposing cardiac condition

Explanation

The Duke criteria major criteria include: (1) positive blood cultures — typical organisms (viridans streptococci, S. aureus, HACEK group) in 2 separate cultures, OR persistently positive cultures ≥12 hours apart, OR single positive culture for Coxiella; and (2) evidence of endocardial involvement on echo (oscillating vegetation, abscess, dehiscence) or new valvular regurgitation. Fever, vascular phenomena (Janeway lesions), and predisposing cardiac conditions are all minor criteria.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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