RESUMO
Austrian syndrome is a triad characterized by pneumonia, meningitis and endocarditis, as a result of a Streptococcus pneumoniae bacteremia. We report a previously healthy 49 year-old male, who consulted at the emergency care unit with a history of one week of pleuritic pain, fever leading to an altered level of consciousness and seizures. A diagnosis of community-acquired pneumonia and meningitis was reached, isolating Streptococcus pneumoniae in the cerebrospinal fluid and blood cultures. Antibiotic treatment was started but the patient had an unsatisfactory response. During hospitalization a new heart murmur was found in the physical examination. An echocardiography was performed and a massive aortic valve insufficiency was found along with vegetations and a perforation of the same valve. The valve was replaced by a prosthetic one and the patient responded satisfactorily to the surgical and antibiotic treatment, without complications.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Pneumocócica/microbiologia , Streptococcus pneumoniae/isolamento & purificação , Meningites Bacterianas/microbiologia , Endocardite Bacteriana/microbiologia , Pneumonia Pneumocócica/cirurgia , Pneumonia Pneumocócica/diagnóstico por imagem , Síndrome , Tomografia Computadorizada por Raios X , Meningites Bacterianas/cirurgia , Meningites Bacterianas/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Endocardite Bacteriana/diagnóstico por imagemAssuntos
Endocardite Bacteriana/microbiologia , Meningites Bacterianas/microbiologia , Pneumonia Pneumocócica/microbiologia , Streptococcus pneumoniae/isolamento & purificação , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Humanos , Masculino , Meningites Bacterianas/diagnóstico por imagem , Meningites Bacterianas/cirurgia , Pessoa de Meia-Idade , Pneumonia Pneumocócica/diagnóstico por imagem , Pneumonia Pneumocócica/cirurgia , Síndrome , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To evaluate the predictive value of cerebral ultrasound in infants diagnoses on meningitis neonatal to the neurological outcome. METHOD: A retrospective study of 16 children admitted at Institute Fernandes Figueira RJ-Brazil, who had neonatal meningitis and were examined by cerebral ultrasound. The neurologic outcome was evaluated until 12 years of age. Positive and negative predictive values, sensitivity and specificity were calculated. RESULTS: 56.25% were male and 81.25% premature. Hydrocephalus was the most frequent finding (56.25%) followed by normal exam (43.75%). Findings of hydrocephalus (9) only one had good neurologic outcome; and normal exam (7): only 57.14% without brain damage. Findings of ventriculitis (4) and brain abscesses (2) all had neurologic damage. Diagnosis of encephalomalacia (2): only one had good cognitive function. Findings of cerebral atrophy (2) all with severe outcome. CONCLUSION: The positive and predictive values were: 88.89%; 57.14% negative; sensitivity was 72.73% and specificity 80%.