Invasive Pneumococcal Disease Associated with Austrian Syndrome

Austrian syndrome (AS) is named in honor of the eminent doctor Robert Austrian, an American physician specializing in infectious diseases who described this pathology in 1957. AS is a clinical entity caused by disseminated Streptococcus pneumoniae infection and is usually characterized by the triad of pneumonia, endocarditis, and meningitis. Before the discovery of penicillin, S. pneumoniae was one of the most common causes of endocarditis, but today it represents fewer than 1% of such cases. Current estimates place the occurrence rate of AS at 0.9-7.8 cases per 10 million people per year, with a mortality rate of approximately 32%. Alcohol abuse is the main risk factor, but it appears in only 40% of patients with AS. Additionally, 14% of AS patients have no associated risk factors. The majority of patients with AS are males, and it generally appears in middle age. AS more frequently affects the native valve, and in 50% of cases, the aortic valve is damaged. Timely and appropriate antimicrobial treatment and early surgery for endocarditis both decrease the risk of mortality. We present a case of a patient without predisposing factors who presented with this clinical entity and had a satisfactory outcome.