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.