Austrian Syndrome with a Delayed Onset of Heart Failure

Kim, Yong Min; Kim, Kyung‐Sup; Kim, Min Gang; Kwon, Young Soo; Jo, Seong Jin; Kim, Hyun Sook; Han, Sang Jin; Park, Woo Jung; Rhim, Chong Yun

doi:10.4250/jcu.2011.19.1.35

Cited by 8 publications

(3 citation statements)

References 11 publications

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“…Streptococcus pneumoniae remains as the predominant organism for community acquired pneumonia and meningitis, but its role in causation of infective endocarditis has fallen to less than 3% cases from 15–30% in the pre-penicillin era [ 4 , 5 ]. It is not uncommon that, during an episode of invasive pneumococcal infection like meningitis; the possibility of valvular involvement is easily overlooked in absence of peripheral stigmata of infective endocarditis [ 6 , 7 ] resulting in late diagnosis of endocarditis [ 1 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Successful medical management of a case of Austrian syndrome—an uncommon entity in the modern antibiotic era: a case report

et al. 2017

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BackgroundAustrian syndrome—the combination of meningitis, pneumonia and infective endocarditis due to Streptococcus pneumoniae infection, is a rare entity. In literature only a few hundreds of cases are reported but surprisingly we did not find any report on Austrian syndrome in or from Bangladesh.Case presentationWe report the case history of a middle aged Bangladeshi diabetic man, who had fever, cough, shortness of breath and altered mentation. He had tachycardia, bi-basal lung crepitations, new cardiac murmurs and meningism. Diagnostic work-up revealed Austrian syndrome. Because of the rarity of the condition, this case is reported.ConclusionA case of pneumococcal pneumonia or meningitis should raise suspicion of concomitant endocarditis and Austrian syndrome, specially if there is heart failure, as early recognition and treatment may appear life-saving.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2801-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Successful medical management of a case of Austrian syndrome—an uncommon entity in the modern antibiotic era: a case report

et al. 2017

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“…An association of PE with pneumococcal meningitis (and at times, pneumococcal pneumonia) is often referred to as Austrian syndrome. Few cases of Austrian syndrome are reported in the medical literature [ 16 , 17 ]. Martínez et al reported a concerning increase in the resistance of pneumococci to penicillin, but the study did not show any effect of penicillin-resistant strains on clinical characteristics, complications, and mortality.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Mitral Valve Endocarditis Caused byStreptococcus pneumoniaein a Splenectomized Host

Shrestha

Chintanaboina

Pancholy

2013

Case Reports in Infectious Diseases

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A 72-year-old male with a remote history of splenectomy and two previous episodes of pneumococcal endocarditis of mitral valve presented with high-grade fever and confusion for 3 days. Nine months priorly, patient underwent mitral valve repair when he had the first episode of pneumococcal mitral valve endocarditis. He received pneumococcal vaccination two years ago. On examination during this admission, he was found to be febrile (104.3 F) and confused and had a grade 2/6 systolic murmur at the apex without any radiation. Laboratory data was significant for a white blood cell count of 22,000/mm3 (normal: 4000–11000/mm3). Blood cultures (4/4 bottles) grew penicillin-sensitive Streptococcus pneumoniae. Transesophageal echocardiogram revealed small vegetation on the posterior mitral leaflet without any evidence of abscess and severe mitral regurgitation. Patient clinically responded to intravenous ceftriaxone. However, due to recurrent pneumococcal mitral valve endocarditis and severe mitral regurgitation, the patient underwent mitral valve replacement. Patient had an uneventful recovery and was discharged home. Pneumococcal endocarditis itself is being uncommon in this current, penicillin, era; our case highlights the recurrent nature of pneumococcal endocarditis in a splenectomized host and the importance of pursuing aggressive treatment options in this clinical scenario.

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“…Unique to pneumococci is a condition called Austrian Syndrome, which consists of meningitis, pneumonia, and endocarditis and is most often observed in middle-aged men with pre-existing conditions such as alcoholism. Although Austrian Syndrome is clinically rare, it is highly aggressive and often fatal because endocarditis is recognized too late [8].…”

Section: Introductionmentioning

confidence: 99%

Two-Component System Response Regulators Involved in Virulence of Streptococcus pneumoniae TIGR4 in Infective Endocarditis

Trihn

Dobson

et al. 2013

PLoS ONE

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Streptococci resident in the oral cavity have been linked to infective endocarditis (IE). While other viridans streptococci are commonly studied in relation to IE, less research has been focused on Streptococcus pneumoniae. We established for the first time an animal model of S. pneumoniae IE, and examined the virulence of the TIGR4 strain in this model. We hypothesized that two-component systems (TCS) may mediate S. pneumoniae TIGR4 strain virulence in IE and examined TCS response regulator (RR) mutants of TIGR4 in vivo with the IE model. Thirteen of the 14 RR protein genes were mutagenized, excluding only the essential gene SP_1227. The requirement of the 13 RRs for S. pneumoniae competitiveness in the IE model was assessed in vivo through use of quantitative real-time PCR (qPCR) and competitive index assays. Using real-time PCR, several RR mutants were detected at significantly lower levels in infected heart valves compared with a control strain suggesting the respective RRs are candidate virulence factors for IE. The virulence reduction of the ΔciaR mutant was further confirmed by competitive index assay. Our data suggest that CiaR is a virulence factor of S. pneumoniae strain TIGR4 for IE.

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Austrian Syndrome with a Delayed Onset of Heart Failure

Cited by 8 publications

References 11 publications

Successful medical management of a case of Austrian syndrome—an uncommon entity in the modern antibiotic era: a case report

Successful medical management of a case of Austrian syndrome—an uncommon entity in the modern antibiotic era: a case report

Recurrent Mitral Valve Endocarditis Caused byStreptococcus pneumoniaein a Splenectomized Host

Two-Component System Response Regulators Involved in Virulence of Streptococcus pneumoniae TIGR4 in Infective Endocarditis

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