Síndrome de Austrian: encontrando lo que se busca. Reporte y seguimiento de un caso.

The association of meningitis, pneumonia and infective endocarditis caused by Streptococcus pneumoniae is known as Austrian syndrome. This triad is rare but deadly, with a mortality rate over 25%. We present the case of a male patient with history of risk factors who was admitted to the Intensive Care Unit (ICU) with meningitis, pneumonia and septic arthritis and who developed shock and multiple organ dysfunction syndrome in a short time. The high suspicion of Austrian syndrome led to the prompt diagnosis of a native aortic valve infective endocarditis. The patient received multidisciplinary care including urgent surgery with valve replacement within the first 48 hours and the outcome was initially favourable. After 9 months of follow up a paravalvular leak was detected and the patient underwent a second complex surgery followed by a refractory postcardiotomy cardiogenic shock. He finally died after withdrawal of life-sustaining therapy respecting patient’s and family’s wishes.