Meningitis

Generalities
Agent	There are several agents causing meningitis. 1) Main Bacteria: - Neisseria meningitidis (meningococcus): Gram negative diplococci. Main invasive serotypes are A, B, C, W135, X, and Y. - Haemophilus influenza: Gram negative cocco-bacilli. There are 6 serotypes from (a) to (f). The serotype (b) is responsible of invasive infection. - Streptococcus pneumonia (pneumococcus): Gram positive diplococci. There are more than 90 serotypes. - Leptospira: spirochetes, Leptospira interrogans (26 serogroups) - Listeria monocytogenes: Gram positive, rod-shapped - Other bacterial agents: Staphylococcus, enteric bacteria, group B streptococci, Mycobacterium tuberculosis… 2) Virus: - Mumps - Measles - West Nile virus: a Flavivirus - Enterovirus: including Coxsackieviruses A (2-4, 7, 9-10), Coxsackieviruses B (1-6), Echoviruses (2, 5-7, 9-11, 14, 18, 30), Enterovirus 71, Poliovirus (1-3) - Herpes Simplex virus (types 1 and 2): family Herpesviridae - Varicella-Zoster virus: Human (alpha) Herpesvirus 3 (varicella-zoster) from the group Herpesvirus - Adenovirus: Adenovirus, several types (1, 2, 3, 4, 5 and 7), genus Mastadenovirus, family Adenoviridae, - Lymphocytic choriomeningitis virus: an Arenavirus - Sandfly fever viruses: genus Phlebovirus, family Bunyaviridae. They include more than 60 antigenically distinct virus serotypes. Two main groups are identified: a) Sandfly fever group including the Naples serocomplex (Karimabad virus, Arabia virus, Massilia virus, Punique virus, Tehran virus, Toscana virus …) and Sicilian serocomplex; and b) Uukuniemi group -Other virus: arboviruses… 3) Parasites: - Candida albicans, cryptococcus…
Incubation period	varies with the agent
Period of transmissibility	varies with the agent
Reservoir	varies with the agent
Modes of transmission	varies with the agent
Clinical presentation	varies with the agent
Resources
Case definition	- MOPH circular no. 52 (2007): Meningitis - MOPH circular no. 63 (2007): Neisseria meningitidis - MOPH circular no. 54 (2007): Haemophilus influenzae b - MOPH circular no. 36 (2012): West Nile Virus
Forms	- Meningitis reporting form - Meningitis investigation form
Data	- Weekly report

ATC	Name	B/G	Ingredients	Dosage	Form	Price
L02BA03	FASLODEX	B	Fulvestrant - 250mg/5ml	250mg/5ml	Injectable solution	L.L
A09AA02	CREON 25,000	B	Pancreatin protease - 1000FIP-U, Pancreatin amylase - 18000FIP-U, Pancreatin lipase - 25000FIP-U		Capsule	4,598,629 L.L
B05DB	DIANEAL PD4 1.36% GLUCOSE	B	Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 13.6g/l	1.36%	Injectable solution	1,163,270 L.L
L01EX03	VOTRIENT	B	Pazopanib HCl - 400mg	400mg	Tablet, film coated	77,725,025 L.L
N04BC05	SIFROL ER	B	Pramipexole (dihydrochloride monohydrate) - 0.75mg	0.75mg	Tablet, extended release	942,034 L.L
R07AA01	SURVANTA	B	Colfosceril palmitate - 200mg/8ml	200mg/8ml	Suspension	36,957,499 L.L
B05DB	DIANEAL PD4 CYCLER 1.36% GLUCOSE	B	Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 13.6g/l		Injectable solution	1,150,329 L.L
C05CA53	DAFLON	B	Hesperidin - 50mg, Diosmin - 450mg		Tablet, film coated	627,574 L.L
L01EX03	VOTRIENT	B	Pazopanib HCl - 200mg	200mg	Tablet, film coated	42,465,160 L.L
L04AA32	OTEZLA	B	Apremilast - 4x10mg- 4x20mg- 19x30mg		Tablet, film coated	34,751,325 L.L
N02BE01	DOLIPRANE	B	Paracetamol - 1,000mg	1000mg	Tablet	120,946 L.L
N04BC05	SIFROL ER	B	Pramipexole (dihydrochloride monohydrate) - 0.375mg	0.375mg	Tablet, extended release	473,033 L.L
R03AK07	SYMBICORT	B	Formoterol fumarate dihydrate - 9mcg/Inhalation, Budesonide - 320mcg/Inhalation		Inhalation powder	3,378,420 L.L
B05DB	DIANEAL PD4 2.27% GLUCOSE	B	Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 22.7g/l		Injectable solution	1,163,270 L.L
C05CA53	DAFLON	B	Hesperidin - 50mg, Diosmin - 450mg		Tablet, film coated	1,191,988 L.L
G04CA01	XATRAL XL	B	Alfuzosin HCl - 10mg	10mg	Tablet, prolonged release	1,061,636 L.L
J01DC04	CECLOR	B	Cefaclor (monohydrate) - 250mg/5ml	250mg/5ml	Granules for suspension	851,100 L.L
L01AA09	RIBOMUSTIN	B	Bendamustine HCl - 100mg	100mg	Injectable powder for concentrate for solution	31,939,807 L.L
L01EX05	STIVARGA	B	Regorafenib - 40mg	40mg	Tablet, film coated	272,778,486 L.L
N02BE01	DOLIPRANE	B	Paracetamol - 1000mg	1000mg	Tablet	120,946 L.L
N04BC05	SIFROL ER	B	Pramipexole (dihydrochloride monohydrate) - 1.5mg	1.5mg	Tablet, extended release	1,847,783 L.L
B05DB	DIANEAL PD4 CYCLER 2.27% GLUCOSE	B	Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 22.7g/l		Injectable solution	1,150,329 L.L
C05CA53	DAFLON	B	Hesperidin - 100mg, Diosmin - 900mg		Tablet, film coated	1,256,493 L.L
C09CA08	OLMETEC	B	Olmesartan medoxomil - 10mg	10mg	Tablet, film coated	710,893 L.L
D10AF51	DUAC ONCE DAILY	B	Clindamycin (phosphate) - 1%, Benzoyl peroxide - 5%		Gel	1,658,302 L.L
J01MA14	AVALOX	B	Moxifloxacin (HCl) - 400mg	400mg	Tablet, film coated	1,087,169 L.L
L01AA09	RIBOMUSTIN	B	Bendamustine HCl - 100mg	100mg	Injectable powder for concentrate for solution	31,939,807 L.L
L01EX07	CABOMETYX	B	Cabozantinib - 20mg	20mg	Tablet, film coated	440,893,501 L.L
L04AA32	OTEZLA	B	Apremilast - 30mg	30mg	Tablet, film coated	49,829,454 L.L
N02BE01	EFFERALGAN	B	Paracetamol - 1g	1g	Tablet, film coated	129,009 L.L