Austrian syndrome in a child-aortic valve endocarditis following pneumococcal meningitis

A 7-year-old girl with a previously healthy heart underwent a Ross procedure after pneumococcal sepsis, meningitis and aortic valve endocarditis with extensive para-valvular involvement. While pneumococcal infections including respiratory tract infections, bacteraemia and meningitis are common in childhood, endocarditis caused by Streptococcus pneumoniae occurs rarely. Pneumococcal meningitis and aortic valve endocarditis is a known combination, described as Austrian syndrome. We suggest that children with pneumococcal meningitis should be screened with echocardiography for an aortic valve endocarditis. In case of aortic valve endocarditis and persistent infection, surgery should be considered early.