{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:47:21Z","timestamp":1789688841878,"version":"4.0.1"},"reference-count":16,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:sec>\n                      <jats:title>Background<\/jats:title>\n                      <jats:p>\n                        Although rare, Austrian syndrome remains a life-threatening triad consisting of pneumonia, endocarditis, and meningitis caused by\n                        <jats:italic toggle=\"yes\">Streptococcus pneumoniae<\/jats:italic>\n                        .\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Case Summary<\/jats:title>\n                      <jats:p>We present a case of Austrian syndrome, further complicated by spondylodiscitis and endophthalmitis, in an immunocompromised male receiving methotrexate treatment for rheumatoid arthritis. The infection was caused by a non-vaccine pneumococcal serotype (23B). Susceptibility testing showed reduced susceptibility towards benzylpenicillin, an uncommon finding in Denmark.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Conclusion<\/jats:title>\n                      <jats:p>This case illustrates some of the challenges faced in managing invasive pneumococcal disease and underlines the importance of continued awareness of this disease, particularly in immunocompromised patients.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/asmcr.00061-25","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T13:02:22Z","timestamp":1755781342000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Multisite infection with Austrian syndrome caused by non-vaccine pneumococcal serotype\u2014case report"],"prefix":"10.1128","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9169-8552","authenticated-orcid":false,"given":"Frederik Juel Pontoppidan","family":"B\u00f8rrild","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/035b05819","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital","place":["North Zealand, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Fosb\u00f8l","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051dzw862","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Cardiology, Rigshospitalet, Copenhagen University Hospital","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casper","family":"Roed","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/035b05819","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital","place":["North Zealand, Denmark"]},{"id":[{"id":"https:\/\/ror.org\/035b05819","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Medicine, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Hornb\u00e6k \u00d8vre","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051dzw862","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Microbiology, Copenhagen University Hospital","place":["Herlev-Gentofte, Herlev, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle","family":"Brander Eriksen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051dzw862","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Microbiology, Copenhagen University Hospital","place":["Herlev-Gentofte, Herlev, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kraef","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051dzw862","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannik","family":"Helweg-Larsen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/051dzw862","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5552-0095","authenticated-orcid":true,"given":"Zitta Barrella","family":"Harboe","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/035b05819","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital","place":["North Zealand, Denmark"]},{"id":[{"id":"https:\/\/ror.org\/035b05819","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Medicine, University of Copenhagen","place":["Copenhagen, Denmark"]},{"id":[{"id":"https:\/\/ror.org\/0417ye583","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Bacteria, Parasites and Fungi, Statens Serum Institut","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0137-4269","authenticated-orcid":true,"given":"Christina","family":"Ekenberg","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/035b05819","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital","place":["North Zealand, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-013-0007-6"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2018.05.016"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjab052"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/516279"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.21010\/Ajidv18i1.4"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052116"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinme.2024.100205"},{"key":"e_1_3_3_9_2","unstructured":"Slotved HC Fuursted K. 2023. Resistance in Human Pathogens The Danish Integrated Antimicrobial Resistance Monitoring and Research Programme DANMAP. Copenhagen Denmark Statens Serum Institut and Technical University of Denmark"},{"key":"e_1_3_3_10_2","unstructured":"Statens Serum Institut (Denmark\u2019s central laboratory and center for prevention and treatment of infectious diseases congenital illnesses and biological threats). 2024. Vaccinetyper. Available from: https:\/\/www.ssi.dk\/vaccinationer\/risikogrupper\/invasiv-pneumokoksygdom\/pneumokok-risikogrupper. Retrieved 24 Jul 2024."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.12.056"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2021.2000892"},{"key":"e_1_3_3_13_2","unstructured":"Statens Serum Institut (Denmark\u2019s Central Laboratory and Center for Prevention and Treatment of Infectious Diseases Congenital Illnesses and Biological Threats. 2025. Invasiv pneumokoksygdom - Opg\u00f8relse over sygdomsforekomst 2020-23. Available from: https:\/\/www.ssi.dk\/sygdomme-beredskab-og-forskning\/sygdomsovervaagning\/i\/invasiv-pneumokoksygdom---opgorelse-over-sygdomsforekomst-2020-23. 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