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[Austrian syndrome: a patient with meningitis, pneumonia and endocarditis]

Catrien A Schimmelpenninck1, Ivo R Henkens, Christianne S J Duchateau

  • 1HAGA Ziekenhuis, Afd. Interne Geneeskunde, Den Haag, The Netherlands. caschimmelpenninck@gmail.com

Nederlands Tijdschrift Voor Geneeskunde
|May 21, 2010
PubMed

Insights

Austrian syndrome, a rare triad of Streptococcus pneumoniae meningitis, pneumonia, and endocarditis, often presents with severe symptoms. Alcohol abuse increases risk, highlighting the need for prompt diagnosis and combined treatment.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Neurology

Background:

  • Alcohol abuse is linked to functional asplenia, increasing susceptibility to encapsulated bacteria like Streptococcus pneumoniae.
  • The Austrian syndrome is a rare but severe clinical presentation involving meningitis, pneumonia, and endocarditis.

Observation:

  • A 62-year-old male with a history of alcohol abuse presented with neurological symptoms, later diagnosed with Streptococcus pneumoniae meningitis.
  • The patient developed complications including heart failure, multiple organ failure, and endocarditis with valve insufficiency.
  • Leukocyte scintigraphy revealed extracardial infection foci, complicating surgical intervention.

Findings:

  • Delayed diagnosis of bacterial meningitis (24 hours) contributed to the patient's deteriorating condition.
  • Despite antibiotic therapy, the patient's haemodynamic status became unsustainable, necessitating high-risk double heart valve replacement.
  • The patient ultimately succumbed to the severe, multi-systemic infection.

Implications:

  • Early recognition of Austrian syndrome is critical for timely intervention.
  • A combined approach of antibiotics and surgical management may be necessary for severe cases.
  • Alcohol abuse is a significant risk factor, emphasizing the importance of addressing substance abuse in managing such infections.

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