We excluded immigrant travelers (VFRs—Visiting Friends and Relatives) anti-PD-1 antibody because these represent a population of travelers with very different characteristics. The following variables were recorded: gender, age, time from return to consultation, travel characteristics (geographical area, duration, and type of travel), and prophylactic measures. We evaluated clinical syndromes at consultation and final

diagnoses made. Main diagnoses were analyzed based on the geographical area of travel and on the presenting clinical syndrome. Geographical area of travel was divided into five areas: sub-Saharan Africa, Central America–Caribbean, South America, Indian subcontinent–Southeast Asia, and other (North Africa, West Asia, East Asia, and Pacific islands). Travel Selleck BVD-523 duration (three groups were defined) was categorized as: short term (≤30 days), medium term (>30 and <180 days), and long term (≥180 days). Type of travel (four types were defined) was as follows: organized tours in the usual tourist routes (type A); tours outside the

usual tourist routes (eg, as backpackers and hunters; type B); professional travel of short duration or repeated travel (eg, business travel and airline crews; type C); and professional travel in close contact with local environment (eg, aid workers, missionaries, and expatriates; type D). Preventive measures

were as follows: specific vaccinations for the trip (inside period of validity); correct/ adequate antimalarial chemoprophylaxis; and drug compliance and duration considered if appropriate dosing and duration of prophylaxis. Five presenting clinical syndromes were analyzed: fever (body temperature ≥37.7°C); diarrheal syndrome, classified as acute diarrhea (≥3 loose stools in 24 h) or prolonged ADP ribosylation factor diarrhea (>2 weeks duration); eosinophilic syndrome (absolute number of eosinophils in peripheral blood ≥500/µl); cutaneous syndrome (presence of skin lesions, such as rash, pruritus, or ulcers); and respiratory syndrome (presence of dyspnea, pleuritic pain, hemoptysis, or coughing). Final diagnosis was based on positive standard microbiological studies and other tests as indicated according to clinical manifestations. In those cases where a specific pathogen was not identified, diagnosis was established based on epidemiological/clinical data and response to empiric treatment. A single diagnosis may produce different clinical syndromes, and patients may present with several diagnoses, so the total number of syndromes and symptoms may exceed 100%.