title: Seasonal paradox in acute meningitis at Nawabshah.
abstract: OBJECTIVE
  To assess the reasons for paradoxical increase in cases of meningitis in the summer of the year 2001.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Medical Unit III, Peoples Medical College Hospital, Nawabshah, Pakistan, from 1st January, 2001 to 31st December, 2001.
  
  
  METHODS
  A total number of 229 cases of meningitis were admitted throughout the year with typical clinical features or CSF findings. Maximum number (179) was noted from April to July, which was alarming. The reason for this change was assessed in these cases.
  
  
  RESULTS
  One hundred and seventy-nine cases of meningitis presented from 1st April to 31st July 2001. They were predominantly males n= 107 (59.7%) with age range of 15 to 64 years. Presenting symptoms were fever and headache in all and altered sensorium in 160 (89%) cases with positive signs of meningeal irritation in 175 (97.8%). Cerebrospinal fluid examination revealed altered biochemistry and neutrophil leucocytosis in all cases. Organism was identified in 139 (77.65%) cases on gram staining. Culture was done only in 61 (34.07%). Predisposing factors were smoking in 93 (52%) and diabetes in 17 (9.5%) cases. Five female patients were pregnant.
  
  
  CONCLUSIONS
  Common organisms detected were gram positive diplococci (Streptococcus pneumoniae) in 83 (59.7%), gram negative diplococci (Nisseria meningitides) in 51 (36.7%) and Haemophilus influenzae in 5 (3.6%). As the frequency of isolates were approximately same as in other seasons, the increased in meningitis cases during summer was probably due to hot and dry weather causing low absolute humidity.
authors.affiliation: Department of Medicine, Peoples Medical College, Nawabshah. mamoon@isb.comsats.net.pk
authors.forename: Shams uddin
authors.initials: Su
authors.lastname: Shaikh
authors.forename: Rasool Bux
authors.initials: RB
authors.lastname: Shaikh
authors.forename: Muhammad Saleem
authors.initials: MS
authors.lastname: Faiz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006813:Humidity; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011247:Pregnancy; D012621:Seasons