A total of 249 (54%) patients were hospitalized; for those the median length of hospitalization was 5 days. Ten patients (2%) were referred because of a recent history of being treated for malaria in an endemic area. The final diagnoses regarded as the main cause of fever, including potentially life-threatening illnesses, are presented in Table 2. An etiological or clinical diagnosis was established in 346 Pictilisib mw (75%) cases. The discharge diagnosis differed from the working diagnosis in 193 (43%) cases. The final diagnosis was different from the working diagnosis in 256 (55%) and from the discharge

diagnosis in 115 (25%) cases. The data below describe the final diagnoses. The most common main groups of diagnosis were acute diarrheal disease (126/27%), systemic febrile illness (95/21%), and respiratory illness (69/15%). Campylobacter was the most common specific cause of acute diarrheal disease and the most common single specific diagnosis. Malaria was diagnosed in 20 patients, 8 of whom were VFRs. Plasmodium falciparum was the causative pathogen in 16 cases; in four of them the disease was complicated and required intensive care treatment. Blood cultures were obtained from 428 (93%) of the patients and were positive for bacteria in 21 (5%) of these (Salmonella species 5, Escherichia coli 3, Salmonella paratyphi buy PLX4032 3, Salmonella typhi

2, Staphylococcus aureus 2, Burkholderia pseudomallei 1, Klebsiella pneumoniae 1, Shigella sonnei 1, Streptococcus pyogenes Leukotriene-A4 hydrolase 1, Streptococcus viridians 1, Pseudomonas aeruginosa 1). Nasal swabs for influenza A and B antigen were taken from 47 patients (10% of all), including 20 of the 111 meeting the criteria of influenza-like illness (respiratory symptoms, fever >38.5°C); the test was found positive in 7 patients (15% of those tested). HIV test was taken from 174 patients and repeated in 17 patients. A new HIV diagnosis

was established in five patients (5/174, 3% of those tested). More than one specific diagnosis was established in 45 (10%) patients: 41 patients had two and 4 had three separate diagnoses. The most common group of additional diagnoses was acute diarrheal disease (20/49 diagnoses), followed by respiratory (9/49) and systemic febrile illness (6/49, including 2 Epstein-Barr, 1 dengue, 1 HIV, 1 Herpes simplex virus infection, and 1 viral meningitis), genitourinary (4/49), dermatologic (3/49), and non-diarrheal gastrointestinal disease (3/49), and noninfectious diagnoses (4/49). Patients returning from Central Asia and the Indian Subcontinent had acute diarrheal disease more frequently (38/93, 41%) than travelers from other areas (88/369, 24%) (p = 0.002). Most of the malaria (18/20) and all rickettsiosis cases (6) came from Sub-Saharan Africa, and most dengue cases from Asia (9/14). Rare severe diseases acquired in Asia were diagnosed: two cases of melioidosis and one case each of leptospirosis, hepatitis E, and pulmonary histoplasmosis.