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A difficult case of Austrian syndrome: a case report
Sonia Peribáñez1, Iván De María-Mier2, Diana Batin3
1Department of Cardiology, Hospital Universitario Miguel Servet, Zaragoza, Spain. soniaperibel@gmail.com.
Summary
The Austrian syndrome, a severe triad of pneumonia, meningitis, and endocarditis from pneumococcal infection, can present with late-onset endocarditis. Early diagnosis is crucial to reduce its high mortality rate.
Area of Science:
- Infectious Diseases
- Cardiology
- Pulmonology
Background:
- The Austrian syndrome is a rare, severe triad of pneumonia, meningitis, and endocarditis caused by Streptococcus pneumoniae.
- It has a high mortality rate, exceeding 60% if not diagnosed early.
- Knowledge of this syndrome primarily derives from case reports.
Purpose of the Study:
- To highlight the potential for late presentation of endocarditis in Austrian syndrome.
- To emphasize the importance of considering endocarditis in invasive pneumococcal disease.
Main Methods:
- Case report of a 59-year-old female patient with Streptococcus pneumoniae bacteremia, meningitis, and pneumonia.
- Initial antibiotic treatment followed by echocardiography ruling out endocarditis.
- Readmission due to endocarditis with aortic valve perforation, requiring surgical intervention.
Main Results:
- The patient initially improved with antibiotics but later developed endocarditis with acute aortic valve perforation.
- Urgent aortic valve surgery was required.
- The patient survived the critical event.
Conclusions:
- Invasive pneumococcal disease with multiple foci warrants consideration for infective endocarditis.
- Endocarditis can present late in the course of Austrian syndrome.
- Prompt diagnosis and management are vital due to the high mortality associated with Austrian syndrome.
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