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

Autores/as

DOI:

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

Palabras clave:

Streptococcus pneumoniae, Meningitis, Pneumonia, Endocarditis

Resumen

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.

Descargas

Los datos de descarga aún no están disponibles.

Referencias

Nogué MR, Arraiz I, Martín G et al, Revisión Síndrome de Austrian : Una rara manifestación de la enfermedad neumocócica invasiva . Presentación de un caso y revisión bibliográfica. Rev. Española Quimioter. 2019; 32: 2.

Austrian R. The syndrome of pneumococcal endocarditis, meningitis and rupture of the aortic valve. Trans Am Clin Climatol Assoc. 1956-1957;68:40-7

Kanakadandi V, Annapureddy, N, Agarwal SK et al. The Austrian syndrome: a case report and review of the literature. Infection. 2013;41,695–700

Velazquez C, Araji O, Barquero J et al. Austrian syndrome: A clinical rarity. Int. J. Cardiol. 2008; 127: 2.

Nog R, Zaheer N, Badshah C. Austrian syndrome (Triad of pneumococcal pneumonia, meningitis and endocarditis) in an intravenous drug user: A case report. Infect. Dis. Clin. Pract. 2010;18: 6.

Straus AL, Hamburger M. Pneumococcal endocarditis in the penicillin era. Arch Intern Med. 1966 Sep;118(3):190-8

Henriques-Normark B, Tuomanen EI. The pneumococcus: epidemiology, microbiology, and pathogenesis. Cold Spring Harb Perspect Med. 2013 Jul 1;3(7):a010215.

Kan B, Ries J, Normark B et al. Endocarditis and pericarditis complicating pneumococcal bacteraemia, with special reference to the adhesive abilities of pneumococci: Results from a prospective study. Clin. Microbiol. Infect. 2006; 12: 4.

Lucas MJ, Brouwer MC, van der Ende A, van de Beek D. Endocarditis in adults with bacterial meningitis. Circulation. 2013 May 21;127(20):2056-62.

Daniels CC, Rogers PD, Shelton CM. A Review of Pneumococcal Vaccines: Current Polysaccharide Vaccine Recommendations and Future Protein Antigens. J Pediatr Pharmacol Ther. 2016;21(1):27-35. doi:10.5863/1551-6776-21.1.27.

de Egea V, Muñoz P, Valerio M, et al. Characteristics and Outcome of Streptococcus pneumoniae Endocarditis in the XXI Century: A Systematic Review of 111 Cases (2000-2013). Medicine. 2015 Sep;94(39):e1562

McGill F, Heyderman RS, Panagiotou S, Tunkel AR, Solomon T. Acute bacterial meningitis in adults. Lancet. 2016 Dec 17;388(10063):3036-3047.

Engelen-Lee JY, Brouwer MC, Aronica E, van de Beek D. Pneumococcal meningitis: clinical-pathological correlations (MeninGene-Path). Acta Neuropathol Commun. 2016;4:26. Published 2016 Mar 22. doi:10.1186/s40478-016-0297-4

Descargas

Publicado

2020-12-11

Número

Sección

Relato de Caso

Cómo citar

1.
Jesus GN de, Carvalho T, Caldeira A, Fernandes SM. Austrian Syndrome: a report of an exceptionally rare and deadly syndrome. Medicina (Ribeirão Preto) [Internet]. 2020 Dec. 11 [cited 2024 May 17];53(4):468-71. Available from: https://www.periodicos.usp.br/rmrp/article/view/166259