Aortic-right atrium fistula complicating Austrian Syndrome: a case report and literature review.

The triad of pneumonia, meningitis, and endocarditis due to Streptococcus pneumoniae is known as Austrian syndrome. We report a case with an aortic-right atrium fistula in a 39-year-old woman who had undergone splenectomy for Hodgkin's lymphoma. The review of literature shows that the prevalence of Austrian syndrome is decreasing from 19% to 3% of patients with pneumococcal endocarditis in recent years. This case emphasizes that diagnosis of endocarditis should be considered early in every patient with pneumococcal meningitis or bacteremia, particularly in immunocompromised patients.