We herein describe the case of a 65-year-old male patient who presented with 
Osler's triad, which is the combination of endocarditis, pneumonia, and 
meningitis. This report is even more unusual since the pathogen isolated was the 
invasive and virulent strain of Streptococcus pneumoniae serotype 3. The 
clinical entity described is also called Austrian syndrome. Even though rare in 
this antibiotic era, the syndrome remains one of high morbidity and mortality. 
This particular case is of paramount importance for the clinician reader. First, 
it documents the clinical features associated with invasive pneumococcal disease 
and the Austrian syndrome. Second, and equally important, it highlights why 
following the Surviving Sepsis Campaign guidelines saves lives. For this case, 
the following steps were taken: 1. As a surrogate for perfusion, early and 
aggressive fluid resuscitation therapy (guided by lactic acid levels) was 
instituted; 2. also early in the treatment, broad spectrum antibiotics were 
administered; 3. to guide antibiotic therapy, microbiological cultures were 
obtained. The patient subsequently improved and was transferred to the internal 
medicine ward to complete 4 weeks of antibiotic therapy.