An autochthonous case of Zika due to possible sexual transmission, Florence, Italy, 2014
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At the beginning of May 2014, an Italian man is his early 30s (patient 1) returned to Florence, Italy, after a 10-day holiday in Thailand. On the day after his arrival, he developed a confluent maculopapular rash, on the face, trunk, arms, and legs, with fever (maximum temperature 38 °C), conjunctivitis, and frontal headache with retroocular pain. Four days later, patient 1 was admitted to the Infectious and Tropical Diseases Unit of the Florence Careggi University Hospital. Blood tests revealed leucopenia (3,000 cells/µL; reference: 4,000–10,000/µL) while creatinine, platelet count and transaminases were normal. Serological investigation two days after (i.e. 6 days after symptoms onset), showed past exposure to measles and parvovirus, negative results for human immunodeficiency virus (HIV) 1–2 Ab/Ag and chikungunya IgM, a positive result for dengue virus (DENV) IgM, and negative results for DENV IgG, as well as DENV NS1 Ag .