ToolsCalculators
VIRSTA Score
VIRSTA Score
Cerebral or peripheral embolism
Meningitis
Permanent intracardiac device or history of infective endocarditis
Current or past intravenous drug use
Pre-existing native valve disease
Bacteremia persisting >=48 hours despite appropriate therapy
Vertebral osteomyelitis or spondylodiscitis
Community-acquired or non-nosocomial healthcare-associated infection
Severe sepsis or septic shock at presentation
C-reactive protein >190 mg/L
Result0 points
Score <3: low risk of infective endocarditis; echocardiography can generally be deferred pending clinical course.
- VIRSTA score
- 0
When to use
- Deciding which patients with Staphylococcus aureus bacteremia need urgent echocardiography to evaluate for infective endocarditis.
Formula
Weighted sum of 10 clinical/laboratory criteria; score >=3 identifies patients who warrant urgent echocardiography.
Pearls and pitfalls
- Designed for use within the first 48 hours of documented S. aureus bacteremia.
- A score <3 has a high negative predictive value for infective endocarditis in the derivation/validation cohorts, but should not replace clinical judgment in high-suspicion cases.