Three elderly people have died after a fire swept through a hospital in the town of Tivoli, close to Rome, Italian media reports.
A fourth body was found in the mortuary of the San Giovanni Evangelista hospital but that victim was believed to have died before the blaze broke out about 11pm on Friday, Italy's Ansa news agency said.
The fire brigade used turntable ladders to help evacuate about 200 people from the hospital, including children and a pregnant woman.
Those evacuated were taken to hospitals in other parts of Rome for treatment.
The dead - two men and two women - were aged between 76 and 86, the media reports said.
The fire brigade said the fire had been extinguished and an investigation into its cause is under way.
Australian Associated Press