ABSTRACT Background Although rare, Austrian syndrome remains a life-threatening triad consisting of pneumonia, endocarditis, and meningitis caused by Streptococcus pneumoniae . Case Summary We present a case of Austrian syndrome, further complicated by spondylodiscitis and endophthalmitis, in an immunocompromised male receiving methotrexate treatment for rheumatoid arthritis. The infection was caused by a non-vaccine pneumococcal serotype (23B). Susceptibility testing showed reduced susceptibility towards benzylpenicillin, an uncommon finding in Denmark. Conclusion This case illustrates some of the challenges faced in managing invasive pneumococcal disease and underlines the importance of continued awareness of this disease, particularly in immunocompromised patients.
Børrild et al. (Thu,) studied this question.