9.2.3.2 Chronic headache attributed to other systemic infection

History: A 35-year-old male patient, immunocompromised (HIV positive, with a CD4+ count of 180 cells/mm³), reports a diffuse, pressure-like headache of moderate intensity for 4 months. The headache began during an acute episode of disseminated histoplasmosis (confirmed by blood culture and urinary antigen detection), accompanied by fever, weight loss, and hepatomegaly. The patient was treated with liposomal amphotericin B, followed by itraconazole, with resolution of systemic symptoms, but the headache persisted. Examinations: Brain MRI: no focal lesions or meningitis. Cerebrospinal fluid: slight elevation of proteins (45 mg/dL), without pleocytosis or hypoglycorrhachia; cultures and PCR for fungi negative. Serologies: other opportunistic infections (toxoplasmosis, cryptococcosis) excluded.