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- Title
Austrian syndrome: Report of one case and a systematic review of case reports --new insights.
- Authors
Madu, Alpha; Alex-Okoro, Tochi; Okoduwa, Abosede; Cotton, James
- Abstract
Objective: The objective of this review was to gain new insight into the rare condition, Austrian syndrome: the triad of endocarditis, meningitis and pneumonia caused by Streptococcus pneumoniae. Methods: A systematic review of case reports was conducted using the PRISMA guideline. Cases were rigorously screened to meet a set of well-defined inclusion criteria. Relevant data was aggregated and reported using descriptive statistics. Results: Seventy-one cases from 69 case reports were included in the final review. The mean age was 56.5 years with a male-to-female ratio of 2.4:1. Alcoholism was reported in 41% of patients. Altered mental state (69%) and fever (65%) (mean temperature on admission = 38.9°C) were the commonest presenting symptoms. The mean duration of symptoms before presentation to the hospital was 8 days. The aortic valve was most commonly affected (56%). The mean duration of antibiotic therapy was 5.6 weeks. Seventy percent of patients were admitted to the intensive care unit (ICU). Fifty-six percent of patients had valvular surgery. The average length of stay in the hospital was 36.9 days. Mortality was recorded in 28% of patients. Conclusion: Austrian syndrome is rare but deadly. The true incidence is unknown but is commoner in middle-aged men and in alcoholics. Affected patients are usually critically unwell, often requiring ICU admission and prolonged hospital stays. Treatment is aggressive including prolonged courses of antibiotics and often, surgery. Despite these, the case fatality rate is high, with death occurring in over a quarter of patients. Surgery appears to be associated with better prognosis.
- Subjects
TREATMENT of rare diseases; STREPTOCOCCAL disease treatment; PNEUMONIA treatment; HEART valve surgery; STREPTOCOCCAL disease diagnosis; PNEUMONIA diagnosis; PNEUMONIA; ANTIBIOTICS; MEDICAL information storage &; retrieval systems; MENTAL health; AORTIC valve; PATIENTS; DEATH; RARE diseases; PNEUMOCOCCAL meningitis; HOSPITAL admission &; discharge; CINAHL database; INFECTIVE endocarditis; DESCRIPTIVE statistics; FEVER; TREATMENT duration; SYSTEMATIC reviews; OPERATIVE surgery; MEDLINE; INTENSIVE care units; STREPTOCOCCAL diseases; LENGTH of stay in hospitals; ONLINE information services; PEOPLE with alcoholism; PROGNOSIS; THERAPEUTICS; DIAGNOSIS
- Publication
Clinical Medicine, 2024, Vol 24, Issue 3, p1
- ISSN
1470-2118
- Publication type
Article
- DOI
10.1016/j.clinme.2024.100205