Respiratory Syndrome and Respiratory Tract Infections in Foreign-Born and National Travelers Hospitalized with Fever in Italy

Authors

  • Alberto Matteelli,

    Corresponding author
    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Anna Beltrame,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Nuccia Saleri,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Zeno Bisoffi,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Roberto Allegri,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Alberto Volonterio,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Massimo Giola,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Paolo Perini,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Laura Galimberti,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Raffaella Visonà,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Alessra Donisi,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Gloria Giani,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Alfredo Scalzini,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Giovanni Gaiera,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Laura Ravasio,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • C.C. Anna Carvalho,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • Maurizio Gulletta,

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • the SIRL study group

    1. Alberto Matteelli, MD, Anna Beltrame, MD, Nuccia Saleri, MD, Anna C.C. Carvalho, MD: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy; Zeno Bisoffi, MD: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar, Italy; Roberto Allegri, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy; Alberto Volonterio, MD: Division of Infectious Diseases, Niguarda Hospital, Milano, Italy; Massimo Giola, MD: Clinic of Infectious and Tropical Diseases, University Hospital, Varese, Italy; Paolo Perini, MD: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy; Laura Galimberti, MD, and Laura Ravasio, MD: Institute of Infectious and Tropical Diseases, University of Milano, Milano, Italy; Raffaella Visonà, MD: Division of Infectious Diseases, San Anna Hospital, Como, Italy; Alessandra Donisi, MD: Clinic of Infectious Diseases, Civil Hospital, Piacenza, Italy; Gloria Giani, MD: I Division of Infectious Diseases, Sacco Hospital, Milano, Italy; Alfredo Scalzini, MD: Clinic of Infectious Diseases, Poma Hospital, Mantova, Italy; Giovanni Gaiera, MD: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano, Italy; Maurizio Gulletta, MD: Clinic of Infectious Diseases, Spedali Civili, Brescia, Italy.
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  • The SIRL study group (Gruppo di Studio sulle Salute Internazionale delle Regione Lombardia) includes Dr.Caligaris Silvio and Dr. Pizzocolo Cecilia: Institute of Infectious and Tropical Diseases, University of Brescia, Brescia; Dr. Marocco Stefania: Centre for Tropical Medicine, Sacro Cuore Hospital, Negrar; Dr. Cadeo Gian Pietro: Clinic of Infectious Diseases, Spedali Civili, Brescia; Prof. Grossi Paolo: Clinic of Infectious and Tropical Diseases, University Hospital, Varese; Prof. Orani Anna: Clinic of Infectious Diseases, A. Manzoni Hospital, Lecco; Prof. Moroni Mauro: Institute of Infectious and Tropical Diseases, University of Milano, Milano; Dr. Rizzardini Giuliano: Division of Infectious Diseases, San Anna Hospital, Como; Dr. Alberici Francesco: Clinic of Infectious Diseases, Civil Hospital, Piacenza; Prof. Vigevani Marco: I Division of Infectious Diseases, Sacco Hospital, Milano; Dr. Perboni Giorgio: Clinic of Infectious Diseases, Poma Hospital, Mantova; Prof. Lazzarin Adriano: Clinic of Infectious Diseases, IRCCS San Raffaele, Milano; Italy.

Reprint requests: Alberto Matteelli, MD, Institute of Infectious and Tropical Diseases, University of Brescia, Piazza Spedali Civili, 1 25125, Brescia, 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 ≤ 10,000 and an erythrocyte sedimentation rate ≤ 20 mm/h were independently associated with a final diagnosis of RTI; onset of symptoms at ≤ 16 days and ≤ 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.

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