J Cardiovasc Ultrasound.  2011 Mar;19(1):35-37. 10.4250/jcu.2011.19.1.35.

Austrian Syndrome with a Delayed Onset of Heart Failure

• Kim YM
• Kim SA
• Kim MG
• Kwon YS
• Kim EJ
• Jo SH
• Kim HS
• Han SJ
• Park WJ
• Rhim CY

• KMID: 2135431
• DOI: http://doi.org/10.4250/jcu.2011.19.1.35

Abstract

A 59-year-old man treated with pneumococcal meningitis 4 months ago was hospitalized for acute heart failure and performed aortic valve replacement by rupture of aortic valve. The frequent association of pneumococcal meningitis and endocarditis is known as Austrian syndrome. Though Austrian syndrome is a clinically rare disease, the evolution of pneumococcal endocarditis is very aggressive and associated with high mortality, and early recognition for evidence of endocardial lesion in patients with pneumococcal meningitis is important to reduce the complications and mortality rate.

Keyword

Pneumococcus; Endocarditis; Meningitis

MeSH Terms

Aortic Valve
Endocarditis
Heart
Heart Failure
Humans
Meningitis
Meningitis, Pneumococcal
Middle Aged
Rare Diseases
Rupture
Streptococcus pneumoniae

Figure

• 

  Fig. 1 Brain magnetic resonance imaging at the first admission with pneumococcal meningitis shows the multiple cerebral infarctions in both high frontal lobes.

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  Fig. 2 Transthoracic echocardiogram at the first admission with pneumococcal meningitis shows a prolaptic motion of non-coronary cusp (A) with trivial aortic regurgitation (B).

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  Fig. 3 Transesophageal echocardiogram at the second admission with heart failure shows a prolaptic motion of non-coronary cusp (A) with aggravated aortic regurgitation (B).

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  Fig. 4 Post-operative finding of aortic valve revealed a rupture of septated large perforation of non-coronary cusp (NCC) (arrow). The free margin of NCC was diffusely thickened, suggesting healed bacterial endocarditis.

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