Abstract
Introduction: Infectious endocarditis caused by Streptococcus pneumonia remains rare but serious. When it is associated with meningitis and pneumonia, it is called Austrian syndrome. Case Report: The authors describe a case of a 66-year-old female Moroccan patient who presented a congestive heart failure due to mitral valve disease after few days of hospitalization for pneumococcal meningitis associated with pneumonitis. The patient had a favorable course after combination of antibiotic therapy followed by surgical valve replacement. Conclusion: The recognition of this syndrome allows an early diagnosis of cardiac involvement often masked and which worsens the prognosis. Mortality can be lowered by appropriate medico-surgical management.
Highlights
INTRODUCTIONDr Robert Austrian described the association of an endocarditis, a meningitis, and a pneumopathy in 1957 at eight patients with a high mortality because of destruction of the aortic sigmoids [1]
Infectious endocarditis caused by Streptococcus pneumonia remains rare but serious
Austrian syndrome is rare infectious disease caused by Streptococcus pneumonia with only a few reported cases worldwide
Summary
Dr Robert Austrian described the association of an endocarditis, a meningitis, and a pneumopathy in 1957 at eight patients with a high mortality because of destruction of the aortic sigmoids [1]. A 66-year-old female patient was hospitalized for agitation, fever, and disorder of consciousness following a few days of a respiratory signs including cough, expectoration with progressive dyspnea. She had a history of type II diabetes under insulin therapy, arterial hypertension treated by antagonists of angiotensin II receptors and diuretics, obesity and dyslipidemia treated by statins and aspirin. Transesophageal echocardiography showed a small, thickened mitral valve truncated with small vegetations, a prolapse P2–P3 by cord rupture responsible of severe mitral insufficiency grade III–IV, with moderate pulmonary arterial hypertension at 37 mmHg systolic pressure (Figure 3). Antibiotic therapy was maintained for six weeks for vancomycin, ceftriaxone for three weeks, and gentamycin for one week
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