9.1.1.3 Persistent headache attributed to past bacterial meningitis or meningoencephalitis

Identification: A 32-year-old male patient reports a continuous headache for 4 months following treatment for bacterial meningitis caused by Streptococcus pneumoniae. Current Illness History: Previous hospitalization for bacterial meningitis confirmed by CSF culture (leukocytosis > 1,000 cells/mm³, elevated protein, low glucose). Treatment with ceftriaxone and dexamethasone for 14 days, with resolution of acute symptoms (fever, neck stiffness, photophobia). Since then, he has experienced a daily, diffuse, pressure-like headache of moderate intensity (5-6/10), without worsening with physical activity. No signs of active infection (afebrile, no focal neurological changes). Complementary Examinations: Cranial MRI without alterations (no hydrocephalus, abscess, or parenchymal lesions). Follow-up lumbar puncture: normal CSF (cells < 5/mm³, normal protein and glucose).