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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
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ATC Name B/G Ingredients Dosage Form Price
B05BA02 LIPIDEM G Triglycerides, Medium Chain - 100g/500ml, Soya bean oil - 80g/500ml, Omega-3 acid triglicerides - 20g/500ml Injectable emulsion 2,486,109 L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 628,918 L.L
G01AF20 MICOGYL G Metronidazole - 500mg, Miconazole nitrate - 100mg Suppository 362,198 L.L
R03AK06 SEROFLO-S 250 G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,725,494 L.L
A03CA02 LIBROCOL G Chlordiazepoxide - 5mg, Clidinium bromide - 2.5mg Tablet 338,648 L.L
B05BA10 OLIMEL N9E B Glucose solution - 27.5%, Amino acids solution - 14.2%, Lipid emulsion - 20%, Sodium - 70mmol/2l, Potassium - 60mmol/2l, Magnesium - 8mmol/2l, Calcium - 7mmol/2l, Phosphate - 30mmol/2l, Acetate - 107mmol/2l, Chloride - 90mmol/2l, Azote - 18g/2l Injectable emulsion 4,711,512 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 12.5mg Tablet, film coated 1,846,440 L.L
G01AX OVUMIX G Metronidazole - 300mg, Miconazole - 100mg, Neomycin (sulfate) - 48.8mg, Gotu Kola - 15mg, Polymixin sulfate - 4.4mg Suppository 395,090 L.L
R03AK07 SYMBICORT B Formoterol fumarate dihydrate - 4.5mcg/Inhalation, Budesonide - 160mcg/Inhalation Inhalation powder 3,378,420 L.L
A03CA02 PRIMAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
B05BA10 PERIOLIMEL N4E B Olive oil + Soja oil - 45.00g, Alanine - 5.50g, Arginine - 3.72g, Aspartic Acid - 1.10g, Glutamic Acid - 1.90g, Glycine - 2.63g, Histidine - 2.26g, Isoleucine - 1.90g, Leucine - 2.63g, Lysine - 2.99g, Methionine - 1.90g, Phenylalanine - 2.63g, Proline - 2.26g, Serine - 1.50g, Threonine - 1.90g, Tryptophan - 0.64g, Tyrosine - 0.10g, Valine - 2.43g, Sodium acetate, 3H2O - 1.73g, Sodium glycerophosphate, H2O - 2.87g, Potassium chloride - 1.79g, Magnesium chloride, 6H2O - 0.67g, Calcium chloride 2H2O - 0.44g, Glucose monohydrate - 123.75g Injectable emulsion 5,288,020 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 25mg Tablet, film coated 1,846,440 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 1,131,515 L.L
R03AK07 SYMBICORT TURBUHALER B Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Inhalation powder 1,689,210 L.L
A03CA02 ULCEDEX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
B05BA10 SMOFKABIVEN G Glucose monohydrate - 462mg, Soya-bean oil, refined - 60mg, Triglycerides, Medium Chain - 60mg, Olive oil, refined - 50mg, Fish oil, rich in omega-3-acids - 30mg, Alanine - 14mg, Arginine - 12mg, Proline - 11.2mg, Glycine - 11mg, Lysine acetate - 9.3mg, Leucine - 7.4mg, Serine - 6.5mg, Valine - 6.2mg, Sodium acetate, 3H2O - 5.62mg, Phenylalanine - 5.1mg, Isoleucine - 5mg, Potassium chloride - 4.48mg, Threonine - 4.4mg, Methionine - 4.3mg, Sodium glycerophosphate, anhydrous - 4.18mg, Histidine - 3mg, Magnesium sulfate, 7H2O - 2.47mg, Tryptophan - 2mg, Taurine - 1mg, Calcium chloride 2H2O - 0.74mg, Tyrosine - 0.40mg, Zinc sulfate heptahydrate - 23mcg Injectable emulsion 3,835,326 L.L
C07BB03 ATONIUM PLUS G Chlortalidone - 25mg, Atenolol - 50mg Tablet 738,473 L.L
C09DB01 EXFORGE B Amlodipine - 5mg, Valsartan - 160mg Tablet, film coated 1,333,092 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 595,322 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Metered dose inhaler 2,365,163 L.L
A03CB01 RESTROPINAL PEDIATRIC B Butobarbital - 2mg/ml, Methyl hyoscine nitrate - 0.1mg/ml Drops 197,097 L.L
B05BA10 SMOFKABIVEN PERIPHERAL G Glucose monohydrate - 143mg, Soya-bean oil, refined - 60mg, Triglycerides, Medium Chain - 60mg, Olive oil, refined - 50mg, Fish oil, rich in omega-3-acids - 30mg, Alanine - 14mg, Arginine - 12mg, Proline - 11.2mg, Glycine - 11mg, Lysine acetate - 9.3mg, Leucine - 7.4mg, Serine - 6.5mg, Valine - 6.2mg, Sodium acetate, 3H2O - 5.62mg, Phenylalanine - 5.1mg, Isoleucine - 5mg, Potassium chloride - 4.48mg, Threonine - 4.4mg, Methionine - 4.3mg, Sodium glycerophosphate, anhydrous - 4.18mg, Histidine - 3mg, Magnesium sulfate, 7H2O - 2.47mg, Tryptophan - 2mg, Taurine - 1mg, Calcium chloride 2H2O - 0.74mg, Tyrosine - 0.40mg, Zinc sulfate heptahydrate - 23mcg Injectable emulsion 4,571,752 L.L
C07BB03 TENORETIC B Chlortalidone - 25mg, Atenolol - 100mg Tablet, film coated 291,614 L.L
C09DB01 AMLODIPINE/VALSARTAN ARROW G Amlodipine (besylate) - 5mg, Valsartan - 160mg Tablet, coated 923,220 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions Capsule 831,839 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Metered dose inhaler 1,182,581 L.L
A03DB04 PANADOL WOMAN B Paracetamol - 500mg, Hyoscine butylbromide - 10mg Tablet, coated 436,749 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 147,095 L.L
C07BB03 ATONIUM PLUS G Chlortalidone - 25mg, Atenolol - 100mg Tablet 738,473 L.L
C09DB01 ARBITEN AM 5/160 G Amlodipine - 5mg, Valsartan - 160mg Caplet, film coated 857,372 L.L
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