What is the cause of my fever, ocular pressure, myalgia, and fatigue despite negative Influenza A, Influenza B, and COVID-19 (Coronavirus Disease 2019) tests?

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Last updated: June 3, 2025View editorial policy

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From the Guidelines

You likely have a condition known as long COVID, which can cause a range of symptoms including fever, ocular pressure, myalgia, and fatigue, despite testing negative for COVID-19. This condition is characterized by persistent symptoms that can last for weeks or even months after the initial infection, and can be caused by the ongoing effects of the SARS-CoV-2 virus on the body 1.

Some key points to consider:

  • Long COVID can cause a range of neurological and cognitive symptoms, including fatigue, cognitive impairment, and sensitivity to light and noise 1.
  • The condition can also cause ocular symptoms, including corneal small nerve fibre loss and increased dendritic cell density, as well as significantly altered pupillary light responses and impaired retinal microcirculation 1.
  • Treatment for long COVID typically focuses on managing symptoms, and may include medications such as acetaminophen or ibuprofen for pain and fever, as well as rest and hydration.
  • It's also important to note that long COVID can have a significant impact on quality of life, and may require ongoing medical care and support to manage symptoms and prevent complications.

In terms of specific recommendations, you should take acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Advil/Motrin) 400mg every 6-8 hours for fever and pain, stay well-hydrated with at least 2-3 liters of fluid daily, and get plenty of rest. Warm compresses may also help relieve ocular pressure. If your fever exceeds 103°F (39.4°C), persists beyond 5 days, or if you develop difficulty breathing, severe headache, stiff neck, or confusion, seek immediate medical attention as these could indicate a more serious condition requiring specific treatment.

It's also important to note that while the provided evidence from studies 1, 1, and 1 discusses cardiovascular sequelae of COVID-19, these studies are not directly relevant to your symptoms and condition, and should not be used to guide treatment decisions. Instead, the most recent and highest quality study on long COVID, 1, should be used to inform treatment and management of your condition.

From the Research

Symptoms and Possible Causes

  • You are experiencing a moderate fever, pressure behind the eyes, aches, and fatigue, despite testing negative for Flu A, B, and COVID-19.
  • The absence of sinus drainage or congestion suggests that your symptoms may not be related to a typical respiratory infection 2.
  • Fever is a common symptom of many illnesses, including COVID-19, influenza, and other viral infections 3, 4, 2.

Diagnostic Considerations

  • The fact that you have tested negative for Flu A, B, and COVID-19 twice suggests that these illnesses are less likely to be the cause of your symptoms.
  • However, it is possible that you may have a different viral or bacterial infection that is causing your symptoms 5.
  • Further testing or evaluation by a healthcare professional may be necessary to determine the underlying cause of your symptoms.

Treatment Options

  • If you are diagnosed with a viral infection, treatment options may be limited to symptom management and supportive care 6.
  • If you are diagnosed with a bacterial infection, antibiotic treatment may be necessary 5.
  • It is essential to consult with a healthcare professional to determine the best course of treatment for your specific condition.

Next Steps

  • Consider consulting with a healthcare professional to discuss your symptoms and determine the best course of action.
  • They may recommend additional testing or evaluation to determine the underlying cause of your symptoms.
  • In the meantime, it is essential to stay hydrated, rest, and manage your symptoms as best as possible 3, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Comparison of the clinical differences between COVID-19, SARS, influenza, and the common cold: A systematic literature review.

Advances in clinical and experimental medicine : official organ Wroclaw Medical University, 2021

Research

Influenza: Diagnosis and Treatment.

American family physician, 2019

Research

Fever as a predictor of adverse outcomes in COVID-19.

QJM : monthly journal of the Association of Physicians, 2021

Research

Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis.

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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