Symptoms of acute otitis media usually develop suddenly and can include:
- Pain or discomfort in the ear. However, it is difficult to determine if an infant or child who hasn't yet learned to speak has an ear infection. Some children may indicate pain if they have trouble swallowing food. Some parents believe that tugging on the ear indicates an infection, but this gesture is more likely to indicate pain from teething.
- Nasal congestion
- Loss of appetite
If the ear infection is severe, the tympanic membrane may rupture, causing the parent to notice pus draining from the ear. (This usually brings relief from pain.) Pus in the ear may cause hearing loss in some children.
Fevers and colds often make children irritable and fussy, so it is difficult to determine if acute otitis media is present as well. Symptoms are not apparent in about a third of children with acute middle ear infection.