Austrian syndrome, also known as Osler's triad, is a medical condition that was named after Robert Austrian in 1957. The presentation of the condition consists of pneumonia, endocarditis, and meningitis, all caused by Streptococcus pneumoniae. It is associated with alcoholism due to hyposplenism (reduced splenic functioning) and can be seen in males between the ages of 40–60 years old. Robert Austrian was not the first one to describe the condition, but Richard Heschl (around 1860s) or William Osler were not able to link the signs to the bacteria because microbiology was not yet developed. Epidemiology Signs of Austrian syndrome usually begin in Caucasian males over 40. A study shows that middle-aged men with alcohol issues make up most patients with Austrian syndrome. Causes The leading cause of Osler's triad (Austrian syndrome) is Streptococcus pneumoniae, which is usually associated with heavy alcohol use. The condition was named Osler's triad because of its associations with pneumonia, meningitis, and endocarditis. Excessive consumption of alcohol would put the user at risk. It was determined that alcoholism completed the tetrad of associated conditions. The oldest recorded patient with Austrian syndrome had a history of health concerns such as hypertension, and diabetes mellitus which increased her risk of Austrian syndrome. Mechanism/pathophysiology Osler's triad, also known as Austrian syndrome, was first introduced in the 19th century. Streptococcus pneumoniae is the cause of Osler's triad of meningitis, pneumonia, and endocarditis. The portal of entry for this triad is said to be the lungs, followed by meningitis and endocarditis. Significant risk factors are heavy alcohol consumption, old age, splenectomy, immunosuppression, etc. Endocarditis typically involves the aortic valve. The native aortic valve is the most frequent vegetation site for Streptococcus pneumoniae and is considered the most common cardiac lesion. In fact it is a historic misnomer because Richard Heschl described the signs before Osler did, but he described this in german, so it got lost in the literature and the name was Osler's triad. Signs and symptoms The presentation of Austrian syndrome includes symptoms from all three of the triad: pneumonia, endocarditis, and meningitis. Cough-producing mucus, shortness of breath, and chest pains during cough are associated with pneumonia. Fever, muscle aches, swollen feet, and shortness of breath are some symptoms of endocarditis, and symptoms of meningitis like headache, confusion, sudden fever, and sensitivity to light. Diagnosis Early diagnosis of Austrian syndrome is beneficial. The disease is usually diagnosed later in