title: Aortic-right atrium fistula complicating Austrian Syndrome: a case report and literature review.
abstract: The triad of pneumonia, meningitis, and endocarditis due to Streptococcus pneumoniae is known as Austrian syndrome. We report a case with an aortic-right atrium fistula in a 39-year-old woman who had undergone splenectomy for Hodgkin's lymphoma. The review of literature shows that the prevalence of Austrian syndrome is decreasing from 19% to 3% of patients with pneumococcal endocarditis in recent years. This case emphasizes that diagnosis of endocarditis should be considered early in every patient with pneumococcal meningitis or bacteremia, particularly in immunocompromised patients.
authors.affiliation: Infectious Diseases Unit, University Hospital of Trieste, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Luzzati
authors.forename: Bruno
authors.initials: B
authors.lastname: Pinamonti
authors.forename: Donatella
authors.initials: D
authors.lastname: Giacomazzi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
authors.forename: Bartolo
authors.initials: B
authors.lastname: Zingone
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001021:Aortic Valve / Q000382:microbiology / Q000473:pathology; D003131:Combined Modality Therapy; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005402:Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D008586:Meningitis, Pneumococcal / Q000150:complications* / Q000188:drug therapy; D010400:Penicillin G / Q000627:therapeutic use; D011018:Pneumonia, Pneumococcal / Q000150:complications* / Q000188:drug therapy; D013577:Syndrome; D014463:Ultrasonography; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D010400:Penicillin G