SHM Converge Scientific Abstract ePoster Gallery-Austrian Syndrome: A Rare but Devastating Mulit-Organ Crisis

Pdf Summary

Austrian syndrome is a rare but severe invasive infection caused by <em>Streptococcus pneumoniae</em>, defined by the triad of pneumonia, meningitis, and infective endocarditis. This case describes a 50-year-old man who presented after one week of upper respiratory symptoms with altered mental status, fever, and hypoxia requiring intubation. Imaging revealed dense left lower lobe pneumonia with a loculated pleural effusion. Blood cultures and urine antigen testing were positive for <em>S. pneumoniae</em>. Because of seizure-like activity and neurologic decline, brain MRI and lumbar puncture were performed, showing acute lacunar infarcts and confirming pneumococcal meningitis.

The patient was initially treated with broad-spectrum antibiotics and later narrowed to high-dose ceftriaxone based on sensitivities. A transesophageal echocardiogram demonstrated vegetations on the aortic valve with severe regurgitation, confirming infective endocarditis and completing the diagnosis of Austrian syndrome. Despite medical therapy, he developed worsening heart failure due to valvular damage, prompting urgent cardiothoracic surgery. He underwent aortic valve replacement and tricuspid valve repair, after which his respiratory and neurologic status gradually improved.

This case highlights the diagnostic difficulty of Austrian syndrome, which often presents with nonspecific findings such as fever, altered mental status, and respiratory failure. Management requires rapid recognition and a multidisciplinary approach involving infectious disease, cardiology, neurology, and often surgery. Early antibiotics and timely valve intervention are critical to prevent cardiogenic shock and improve survival. Austrian syndrome should be considered in patients with pneumococcal pneumonia and neurologic symptoms, especially when endocarditis is suspected.

Asset Subtitle

Cecelia Hale

Meta Tag

Author List Cecelia Hale, Hariom Joshi

Category Clinical Vignettes

Concept Austrian syndrome

Concept Pneumococcal pneumonia

Concept Meningitis

Concept Infective Endocarditis

Concept Antibiotic Therapy

Distinguished Non-Finalist

Presenter Organization Parkview Health

Presenting Author Cecelia Hale

Track Adult

Keywords

Austrian syndrome

Streptococcus pneumoniae

pneumonia

meningitis

infective endocarditis

aortic valve replacement

tricuspid valve repair

altered mental status

ceftriaxone

multidisciplinary management

Austrian syndrome

Pneumococcal pneumonia

Meningitis

Infective Endocarditis

Antibiotic Therapy