Abstract
Austrian syndrome is a rare triad of meningitis, pneumonia, and endocarditis caused by Streptococcus pneumoniae. It is associated with high morbidity and mortality rates. Most reports describe pneumonia as the initial illness, followed by multi-organ involvement. Here, we present a case of Austrian syndrome initially diagnosed with cerebral infarction. The patient died due to the rapid progression of symptoms. There are few reports of cerebral infarction as an initial symptom; therefore, the relationship between the presence of cerebral infarction and its prognosis is not well known. We did a systematic review of the literature to investigate articles from 1980 to 2022. Austrian syndrome initiated by cerebral infarction was not associated with mortality in these articles. Valve vegetation results in congestive heart failure and this may be related to patient mortality. Therefore, valve replacement surgery in an appropriate time period is critical for patient mortality regardless of the presence or absence of cerebral infarction.