Aortic root fistula complicating Austrian syndrome

Austrian syndrome occurs in 1.2% of all patients with pneumococcal infective endocarditis. It presents with the triad of meningitis, pneumonia, and endocarditis. It is commonly seen in elderly males with a history of alcohol abuse, an immunocompromised state, or recent valve surgery. We present a case of Austrian syndrome presenting with paravalvular complications in the form of aortic root fistula. In this report, we describe the second patient with the community-acquired, pneumococcal, native, aortic valve, endocarditis with Austrian syndrome complicated by the development of an aortic fistula.