Abstract
A 61-year-old man presented with fever and altered mental status. He was intubated for respiratory distress and was found to have multilobar pneumonia for which antibiotic therapy was instituted. However, his mental status continued to deteriorate despite appropriate antibiotic therapy for his pneumonia. The results from lumar puncture revealed meningitis and endocarditis was evident on a trans-esophageal echocardiogram. His blood and respiratory cultures grew Streptococcus pneumoniae. The patient was diagnosed with Austrian syndrome. After appropriate changes to his antibiotic regimen and an aortic valve replacement, he recovered and was discharged.
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References
Austrian R. The syndrome of pneumococcal endocarditis, meningitis and rupture of the aortic valve. Trans Am Clin Climatol Assoc. 1956;68:40–7. discussion 48–50.
Rammeloo L, Hruda J, Sobotka-Plojhar M, Avis W, Schoof P. Austrian syndrome in a child-aortic valve endocarditis following pneumococcal meningitis. Int J Cardiol. 2004;94:321–2.
Atkinson K, Augustine DX, Easaw J (2009) Austrian syndrome: a case report and review of the literature. BMJ Case Rep 2009. doi:10.1136/bcr.03.2009.1724.
Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39:1267–84.
Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM Jr, Musher DM, Niederman MS, Torres A, Whitney CG. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44:S27–72. CID41620 [pii].
Schuchat A, Robinson K, Wenger JD, Harrison LH, Farley M, Reingold AL, Lefkowitz L, Perkins BA. Bacterial meningitis in the United States in 1995. N Engl J Med. 1997;337:970–6. doi:10.1056/NEJM199710023371404.
van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004;351:1849–59. doi:10.1056/NEJMoa040845.
Lefort A, Mainardi JL, Selton-Suty C, Casassus P, Guillevin L, Lortholary O. Streptococcus pneumoniae endocarditis in adults. A multicenter study in France in the era of penicillin resistance (1991–1998). The pneumococcal endocarditis study group. Medicine (Baltimore). 2000;79:327–37.
Buchbinder NA, Roberts WC. Alcoholism. An important but unemphasized factor predisposing to infective endocarditis. Arch Intern Med. 1973;132:689–92.
DeMeo AN, Andersen BR. Defective chemotaxis associated with a serum inhibitor in cirrhotic patients. J Lab Clin Med. 1971;78:980–1.
McFarland W, Libre EP. Abnormal leukocyte response in alcoholism. Ann Intern Med. 1963;59:865–77.
Aronin SI, Mukherjee SK, West JC, Cooney EL. Review of pneumococcal endocarditis in adults in the penicillin era. Clin Infect Dis. 1998;26:165–71.
Sakran W, Levin C, Kenes Y, Colodner R, Koren A. Clinical spectrum of serious bacterial infections among splenectomized patients with hemoglobinopathies in Israel: a 37-year follow-up study. Infection. 2012;40:35–9.
Scheiermann P, Rosch I, Nerlich AG, et al. Unusual presentation of Streptococcus pneumoniae-induced septic shock 36 years after splenectomy. Infection. 2011;39:283–5.
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Kanakadandi, V., Annapureddy, N., Agarwal, S.K. et al. The Austrian syndrome: a case report and review of the literature. Infection 41, 695–700 (2013). https://doi.org/10.1007/s15010-012-0361-3
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DOI: https://doi.org/10.1007/s15010-012-0361-3