title: Renal infarction as a presentation of Austrian syndrome: thromboembolic phenomenon of pneumococcal endocarditis.
abstract: A 52-year-old unvaccinated and splenectomized man presented with fever, altered sensorium, bilateral flank pain and chest discomfort accompanied with paroxysmal atrial fibrillation with a rapid ventricular response. An abdominal computed tomography scan was performed, which revealed a right renal infarct and splenosis. Transthoracic echocardiography was performed, which demonstrated an echodense structure on the mitral valve with mitral regurgitation and a vegetation on the aortic valve with aortic regurgitation. Subsequently, he was found to have pneumococcal infective endocarditis, pneumococcal pneumonia and bacterial meningitis, namely Austrian syndrome. He underwent an early aortic valve and mitral valve repair but still had a poor clinical outcome. Renal infarction has a mortality of approximately 13.2%, which is strongly influenced by the underlying diseases and infectious complications. Medical and surgical treatment initiated in a timely manner is often inadequate. The authors report the first case of Austrian syndrome presenting with renal infarction as a clue to an embolic event associated with infective endocarditis in this study.
authors: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA. charoen.mankongpaisarnrung@ttuhsc.edu
authors: Charoen
authors: C
authors: Mankongpaisarnrung
authors: Suthipong
authors: S
authors: Soontrapa
authors: Teerapat
authors: T
authors: Nantsupawat
authors: Vipul
authors: V
authors: Desai
authors: Kenneth
authors: K
authors: Nugent
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001022:Aortic Valve Insufficiency / Q000382:microbiology / Q000601:surgery; D003937:Diagnosis, Differential; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D007238:Infarction / Q000382:microbiology* / Q000473:pathology; D007668:Kidney / Q000098:blood supply* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000382:microbiology / Q000601:surgery; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D013296:Streptococcus pneumoniae / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents