
Having Headache, Lower Back Pain. Diagnosed With Meningitis. Taking Excedrine. Is It Sinus Infection?

Welcome and thank you for posting your query.
Well I read through your post thoroughly, in my humble opinion I feel that our headache is secondary to an infection. Per your description you are having meningoencephalitis (mostly infection of your cerebrum which extends to the meninges). Your MRI not showing any masses rules out possibility of tumor or cerebrovascular diseases or intracranial hemorrhage.
Given the results of your lumbar puncture ( which is very incomplete) which shows elevated white blood cells (but does not show which WBC lineage is elevated like neutrophile or lymphocytes). The specific lineage will tell which type of infection whether viral, bacterial, mycobaceterial, fungal, toxoplasmossi or other atypical germs.
Severe headache due to encephalitis is usually caused by cryptococcal spp. (fungi).
My suggestion is for another CSF analysis (after lumbar tap) be done with indian ink coloration. if confirm then high dose antifungi (specifically fluconazole needs to be started). If actually the infection is viral, then specific virus needs to be determined. Test such as HIV, CMV, Epstein Barr etc should be done. Specific antiviral regimens should also be included. If bacterial encephalitis then high dose antibiotics intravenously needs to be administered. You will require 2nd class analgesia like tramadol to manage the headache.
All the other ENT problems you are manifesting are as a result of the brain infection you are having.
If you had meningitis then you had to manifest with typical signs of meningitis ( neck stiffness, signs of infection and on physical exams brudzinski and kernig signs positive). So your infection might only be cerebral.
In summary, to do away with the headache the infection has to be treated and analgesia given. Upon completion of the treatment you will get a lot of relieve.
Also we can not exclude the fact that a severe upper respiratory tract infection like severe sinusitis can also cause your headache. It has to be treated for the headache to subside.
Hope this helps and write back if you have any follow up questions.
Dr Nsah

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