Austrian Syndrome: a report of an exceptionally rare and deadly syndrome

Gustavo Nobre De Jesus,Tânia Carvalho,Susana M Fernandes,Alexandre Caldeira

doi:10.11606/issn.2176-7262.v53i4p468-471

Gustavo Nobre De Jesus, Tânia Carvalho + Show 2 more

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https://doi.org/10.11606/issn.2176-7262.v53i4p468-471

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Abstract

Austrian Syndrome is the rare combination of a triad of endocarditis, meningitis, and pneumonia in the context of pneumococcal infection. Due to the involvement of several anatomical sites, the Austrian syndrome has a high mortality. Importantly, endocarditis is usually not considered during pneumococcal infection. We present a case of Austrian syndrome in a previously healthy 67-year-old woman. She featured with mental state alteration, respiratory failure, and shock, and was diagnosed with ceftriaxone-sensitive pneumococcal bacteremia, meningitis, and pneumonia. A transesophageal echocardiogram revealed vegetation of the mitral valve. Despite an improvement in her medical condition, she remained in a coma and died due to neurological complications. Even though the major cause of mortality in Austrian syndrome is cardiac involvement, meningitis is also linked with high morbidity and eventually death. We emphasize the relevance of an early diagnosis of the triad in order to decrease the very high mortality associated with this syndrome.

Highlights

The triad of pneumonia, meningitis, and endocarditis caused by Streptococcus pneumoniae, known as Austrian syndrome, is a very rare clinical entity
The outcome is mainly determined by cardiac valve destruction and acute cardiac failure[2], meningitis and respiratory failure contribute to its high mortality
We describe a case of Austrian syndrome in a previously healthy patient, with mitral endocarditis in the triad and death due to meningitis

Summary

Introduction

The triad of pneumonia, meningitis, and endocarditis caused by Streptococcus pneumoniae, known as Austrian syndrome, is a very rare clinical entity. RESUMO A síndrome de Austrian é uma entidade extremamente rara, pautada por meningite, endocardite e pneumonia secundárias a doença pneumocócica invasiva. Apesar da principal causa de morte descrita na síndrome de Austrian estar relacionada com complicações de endocardite, apresenta-se um caso único de apresentação e morte por meningite.

Results

Conclusion