Guerini Giusteri Valentina, Bongiovanni Marco, Bernasconi Enos, Pons Marco
Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, CHE.
Division of Infectious Diseases, Ente Ospedaliero Cantonale, Lugano, CHE.
Cureus. 2025 Feb 6;17(2):e78635. doi: 10.7759/cureus.78635. eCollection 2025 Feb.
Austrian syndrome is a rare and life-threatening condition. It is more severe in immunocompromised patients, those with comorbidities, or harmful alcohol consumption. The etiopathogenesis involves hematogenous seeding of and local spread in the infected tissues, presenting with pneumonia, endocarditis, and meningitis. A 68-year-old man was hospitalized for impaired consciousness, left hemiparesis, and aphasia, consistent with meningoencephalitis. A CT scan showed otomastoiditis and bilateral pulmonary consolidations with respiratory failure. A transesophageal echocardiogram revealed endocardial vegetations at the mitral-aortic junction and left ventricular outflow tract, requiring aortic valve replacement. He also developed septic arthritis in both prosthetic hips and bilateral muscular abscesses. The second patient is a 50-year-old man who was hospitalized for lumbar back pain, aphasia, left-sided neglect, and a motor deficit in the right lower limb. A CT scan showed spondylodiscitis at the L5-S1 level, an abscess in the right frontal region (both confirmed on MRI), and bilateral pulmonary consolidations. A transesophageal echocardiogram revealed endocardial vegetation on the aortic valve. In both patients, susceptible to penicillin was isolated from all septic sites. After the initial treatment with empirical broad-spectrum antibiotics, therapy was switched to intravenous ceftriaxone and then oral amoxicillin. From these cases, it appears that Austrian syndrome usually requires an intensive approach, combining both medical and surgical interventions to guarantee a positive outcome. It is mandatory to identify individuals at risk to promote the role of vaccination in preventing the development of Austrian syndrome and, more generally, invasive pneumococcal disease.
奥地利综合征是一种罕见且危及生命的病症。在免疫功能低下的患者、患有合并症的患者或有有害饮酒习惯的患者中病情更为严重。其发病机制涉及感染组织的血行播散和局部扩散，表现为肺炎、心内膜炎和脑膜炎。一名68岁男性因意识障碍、左侧偏瘫和失语入院，符合脑膜脑炎表现。CT扫描显示耳乳突炎和双侧肺部实变伴呼吸衰竭。经食管超声心动图显示二尖瓣 - 主动脉交界处和左心室流出道有心脏内膜赘生物，需要进行主动脉瓣置换。他还在双侧人工髋关节处发生了化脓性关节炎以及双侧肌肉脓肿。第二名患者是一名50岁男性，因腰背痛、失语、左侧忽视和右下肢运动障碍入院。CT扫描显示L5 - S1水平的脊椎椎间盘炎、右侧额叶区域有脓肿（MRI均证实）以及双侧肺部实变。经食管超声心动图显示主动脉瓣有心脏内膜赘生物。在两名患者的所有感染部位均分离出对青霉素敏感的病菌。在经验性使用广谱抗生素进行初始治疗后，治疗改为静脉注射头孢曲松，然后口服阿莫西林。从这些病例来看，奥地利综合征通常需要采取强化治疗方法，结合药物和手术干预以确保取得良好疗效。必须识别出有风险的个体，以促进疫苗接种在预防奥地利综合征以及更广泛的侵袭性肺炎球菌疾病方面的作用。
