Peebles Mitchell, Roshani Mehnaz, Srivastava Kumaraman
PGY-2 Internal Medicine Resident at Texas Health Harris Methodist Hospital Fort Worth Texas USA.
Internal Medicine Core Faculty at Texas Health Harris Methodist Hospital Fort Worth Texas USA.
Clin Case Rep. 2023 Jul 2;11(7):e7648. doi: 10.1002/ccr3.7648. eCollection 2023 Jul.
Austrian Syndrome classically consists of meningitis, endocarditis, and pneumonia due to bacteremia. A literature review, however, does not show variants of this triad. Our case highlights a unique variant of Austrian Syndrome with mastoiditis, meningitis, and endocarditis which requires immediate recognition and treatment to prevent devastating patient outcomes.
is responsible for more than 50% of all bacterial meningitis and has a case fatality rate of 22% in adults. In addition, is also one of the most common causes of acute otitis media, a known cause of mastoiditis. However, in conjunction with bacteremia and endocarditis, limited evidence is able to be identified. This sequence of infections also closely relates to Austrian syndrome. Otherwise known as Osler's triad, Austrian syndrome is a rare phenomenon of meningitis, endocarditis, and pneumonia secondary to bacteremia that was first delineated by Robert Austrian in 1956. The incidence of Austrian syndrome is reported to be less than <0.0001% per year and has decreased significantly since the initial usage of penicillin in 1941. Despite this, the mortality rate of Austrian syndrome is still around 32%. Despite an extensive literature review, we were unable to find any reported cases of variants of Austrian syndrome that include mastoiditis as the primary insult. As such, we present a unique presentation of Austrian syndrome with mastoiditis, endocarditis, and meningitis with complex medical management that led to resolution for the patient. To discuss the presentation, progression, and complex medical management of a previously undiscussed triad of mastoiditis, meningitis, and endocarditis occurring in a patient.
奥地利综合征典型表现为因菌血症导致的脑膜炎、心内膜炎和肺炎。然而，文献综述未显示该三联征的变体。我们的病例突出了一种奥地利综合征的独特变体，伴有乳突炎、脑膜炎和心内膜炎，需要立即识别和治疗以防止患者出现灾难性后果。
[具体病原体未提及]导致超过50%的细菌性脑膜炎，在成人中的病死率为22%。此外，[具体病原体未提及]也是急性中耳炎最常见的病因之一，而急性中耳炎是乳突炎的已知病因。然而，关于其与菌血症和心内膜炎相关的证据有限。这一系列感染也与奥地利综合征密切相关。奥地利综合征又称奥斯勒三联征，是一种继发于[具体病原体未提及]菌血症的脑膜炎、心内膜炎和肺炎的罕见现象，于1956年由罗伯特·奥地利首次描述。据报道，奥地利综合征的发病率每年低于 <0.0001%，自青霉素于1941年首次使用以来已显著下降。尽管如此，奥地利综合征的死亡率仍约为32%。尽管进行了广泛的文献综述，但我们未能找到任何报道的以乳突炎为主要病变的奥地利综合征变体病例。因此，我们呈现了一例独特的奥地利综合征病例，伴有乳突炎、心内膜炎和脑膜炎，经过复杂的医疗管理后患者病情得到缓解。旨在讨论一名患者出现的此前未被讨论过的乳突炎、脑膜炎和心内膜炎三联征的表现、病程及复杂医疗管理情况。
