title: Respiratory syndrome and respiratory tract infections in foreign-born and national travelers hospitalized with fever in Italy.
abstract: BACKGROUND
  We measured frequency and epidemiologic, clinical, and hematochemical variables associated with respiratory tract infections (RTIs) in foreign-born and national patients hospitalized with fever with a history of international travel, and compared the final diagnosis of RTI with the presence of a respiratory syndrome (RS) at presentation.
  
  
  METHODS
  A prospective, multicenter, observational study was conducted at tertiary care hospitals in Northern Italy from September 1998 to December 2000.
  
  
  RESULTS
  A final diagnosis of RTI was obtained in 40 cases (7.8%), 27 (67.5%) with lower RTI and 13 (32.5%) with upper RTI. The most common RTIs were pneumonia (35%) and pulmonary tuberculosis (15%). A white blood cell count > or = 10,000 and an erythrocyte sedimentation rate > or = 20 mm/h were independently associated with a final diagnosis of RTI; onset of symptoms at > or = 16 days and > or = 75% neutrophils were independently associated with lower RTI. An RS was identified in 51 (9.9%) of 515 travelers. Sensitivity, specificity, and positive and negative predictive values of a diagnosis of RS for a final diagnosis of RTI were 67.5%, 94.9%, 52.9%, and 97.2%, respectively.
  
  
  CONCLUSIONS
  Pneumonia and pulmonary tuberculosis were frequent among foreign-born and national travelers with fever admitted to a tertiary care hospital. Half of the pneumonia cases did not present with an RS at first clinical examination.
authors.affiliation: Institute of Infectious and Tropical Diseases, University of Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Matteelli
authors.forename: Anna
authors.initials: A
authors.lastname: Beltrame
authors.forename: Nuccia
authors.initials: N
authors.lastname: Saleri
authors.forename: Zeno
authors.initials: Z
authors.lastname: Bisoffi
authors.forename: Roberto
authors.initials: R
authors.lastname: Allegri
authors.forename: Alberto
authors.initials: A
authors.lastname: Volonterio
authors.forename: Massimo
authors.initials: M
authors.lastname: Giola
authors.forename: Paolo
authors.initials: P
authors.lastname: Perini
authors.forename: Laura
authors.initials: L
authors.lastname: Galimberti
authors.forename: Raffaella
authors.initials: R
authors.lastname: Visonà
authors.forename: Alessra
authors.initials: A
authors.lastname: Donisi
authors.forename: Gloria
authors.initials: G
authors.lastname: Giani
authors.forename: Alfredo
authors.initials: A
authors.lastname: Scalzini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gaiera
authors.forename: Laura
authors.initials: L
authors.lastname: Ravasio
authors.forename: C C
authors.initials: CC
authors.lastname: Anna Carvalho
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gulletta
mesh_terms: D000328:Adult; D001772:Blood Cell Count; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D005334:Fever / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D013577:Syndrome; D014195:Travel; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology