ToolsCalculators
VIRSTA Score
Prioritizes patients with S. aureus bacteremia for urgent echocardiography to rule in infective endocarditis.
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.