Chirteș Ioana Raluca, Florea Dragos, Chiriac Carmen, Mărginean Oana Maria, Mănășturean Cristina, Vitin Alexander A, Georgescu Anca Meda
University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania.
National Institute of Infectious Diseases "Prof. Dr Matei Bals", Laboratory of Molecular Biology, Bucharest, Romania.
J Crit Care Med (Targu Mures). 2018 Feb 9;4(1):17-22. doi: 10.1515/jccm-2017-0025. eCollection 2018 Jan.
Known also as Osler's triad, Austrian syndrome is a complex pathology which consists of pneumonia, meningitis and endocarditis, all caused by the haematogenous dissemination of Streptococcus pneumoniae. The multivalvular lesions are responsible for a severe and potential lethal outcome.
The case of a 51-year-old female patient, with a past medical history of splenectomy, is presented. She developed bronchopneumonia, acute meningitis and infective endocarditis as a result of Streptococcus pneumoniae infection and subsequently developed multiple organ dysfunction syndromes which led to a fatal outcome. Bacteriological tests did not reveal the etiological agent. The histopathological examination showed a severe multivalvular endocarditis, while a PCR based molecular analysis from formalin fixed valvular tissue identified Streptococcus pneumoniae as the etiologic agent.
The presented case shows a rare syndrome with a high risk of morbidity and mortality. Following the broad-spectrum treatment and intensive therapeutic support, the patient made unfavourable progress which raised differential diagnosis problems. In this case, the post-mortem diagnosis demonstrated multiple valvular lesions occurred as a result of endocarditis.
奥地利综合征又称奥斯勒三联征，是一种复杂的病理状况，由肺炎、脑膜炎和心内膜炎组成，均由肺炎链球菌的血行播散引起。多瓣膜病变会导致严重且可能致命的后果。
本文介绍了一名51岁女性患者的病例，其既往有脾切除术病史。她因肺炎链球菌感染而患上支气管肺炎、急性脑膜炎和感染性心内膜炎，随后发展为多器官功能障碍综合征，最终导致死亡。细菌学检测未发现病原体。组织病理学检查显示为严重的多瓣膜心内膜炎，而对福尔马林固定的瓣膜组织进行的基于聚合酶链反应的分子分析确定肺炎链球菌为病原体。
该病例显示了一种罕见的综合征，具有高发病率和死亡率风险。在进行广谱治疗和强化治疗支持后，患者病情进展不利，引发了鉴别诊断问题。在本病例中，尸检诊断表明心内膜炎导致了多处瓣膜病变。
