Abstract
Austrian syndrome is a rare triad of endocarditis, meningitis, and pneumonia caused by Streptococcus pneumonia described by Robert Austrian in 1956. The incidence has reduced since the introduction of beta-lactam therapy in the early 1940s. Additionally, the introduction of the pneumococcal vaccination in 1977 further decreased the incidence of infection. Streptococcal endocarditis could potentially be very aggressive and life threatening despite appropriate therapy. It has a high mortality rate nearing 30 % even after proper antibiotics and surgical intervention. Therefore, an early recognition is crucial for early intervention and mortality reduction. We present a patient with Austrian syndrome who had a poor outcome despite proper management that is attributed to late presentation and delayed treatment.