Respiratory syndrome and respiratory tract infections in foreign-born and national travelers hospitalized with fever in Italy.
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.
Matteelli
Alberto
A
Institute of Infectious and Tropical Diseases, University of Brescia, Italy.
Beltrame
Anna
A
Saleri
Nuccia
N
Bisoffi
Zeno
Z
Allegri
Roberto
R
Volonterio
Alberto
A
Giola
Massimo
M
Perini
Paolo
P
Galimberti
Laura
L
Visonà
Raffaella
R
Donisi
Alessra
A
Giani
Gloria
G
Scalzini
Alfredo
A
Gaiera
Giovanni
G
Ravasio
Laura
L
Anna Carvalho
C C
CC
Gulletta
Maurizio
M
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