BMJ Case Reports 2009; doi:10.1136/bcr.03.2009.1724
  • Reminder of important clinical lesson

Austrian syndrome: a case report and review of the literature

  1. Kate Atkinson1,
  2. Daniel Xavier Augustine2,
  3. Jacob Easaw2
  1. 1
    Royal United Hospital Bath NHS Foundation Trust, Medicine, Combe Park, Bath, BA1 3NG, UK
  2. 2
    Royal United Hospital Bath NHS Foundation Trust, Cardiology, Combe Park, Bath, BA13NG, UK
  1. Kate Atkinson, kateatkinson{at}
  • Published 15 September 2009


A usually fit and well 69-year-old woman presented with headache and altered consciousness. Initial clinical findings and investigations were consistent with a diagnosis of pneumococcal meningitis and pneumonia. Cultures of blood and cerebrospinal fluid grew Streptococcus pneumoniae. The patient continued to spike temperatures and developed cardiac failure. A transoesophageal echocardiogram demonstrated a large vegetation of the aortic valve causing severe aortic regurgitation. A diagnosis of Austrian syndrome, the triad of pneumococcal meningitis, pneumonia and endocarditis, was made. The patient has completed a course of appropriate antibiotic therapy and is awaiting aortic valve surgery.


  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.

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