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Austrian Syndrome — SCE Infectious Diseases MCQ

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ModerateBone & Joint InfectionAustrian SyndromeSCE Infectious Diseases

A 60-year-old man develops native valve endocarditis with Streptococcus pneumoniae. This is an uncommon but well-described presentation. What associated condition should be specifically investigated?

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Correct answer: B — Meningitis — pneumococcal endocarditis has a strong association with concurrent meningitis (Austrian syndrome: pneumococcal meningitis + endocarditis ± pneumonia)

Austrian syndrome (Osler triad) is the combination of pneumococcal meningitis plus pneumococcal endocarditis ± pneumococcal pneumonia. It is named after Robert Austrian who described the triad in alcoholic patients. Any patient with pneumococcal endocarditis should be assessed for concurrent meningitis (LP if no contraindication) and pneumonia. Conversely, severe pneumococcal meningitis should prompt echocardiography to exclude endocarditis. The triad carries high mortality. Treatment follows standard pneumococcal endocarditis and meningitis guidelines.

Reference: ESC 2023 – Endocarditis; NICE CG102 – Meningitis; BSAC 2012