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Symptoms of a middle ear infection (acute otitis media) often start 2 to 7 days after the start of a cold or other upper respiratory infection. Some children don't have any symptoms.
Symptoms may include:
Earache (mild to severe).
Fussiness in babies and young children. They may pull at their ears and cry. They may have trouble sleeping. They may also have a fever.
Drainage from the ear that is thick and yellow or bloody. This means the eardrum has probably burst (ruptured). The hole in the eardrum often heals by itself in a few weeks.
Loss of appetite, vomiting, and grumpy behavior.
Symptoms of fluid buildup
Sometimes fluid builds up in the ear, but there is no infection. The child may have trouble hearing, but hearing usually returns to normal after the fluid is gone. It may take weeks for the fluid to drain away.
Symptoms of fluid buildup may include:
Popping, ringing, or a feeling of fullness or pressure in the ear. Children often have trouble describing this feeling. They may rub their ears trying to relieve pressure.
Trouble hearing. Children who have problems hearing may seem dreamy or inattentive, or they may be grumpy or cranky.