This is a common infection in children, especially children under 5 years of age. Acute otitis media presents with:

• Sudden onset of severe pain in the ear (earache). Infants become irritable, cry and may pull at the affected ear.
• Fever, often above 39 °C.
• On examination, the eardrum is red and bulges with loss of the normal light reflex. The pain is not made worse if the pinna (external ear) is pulled.
• The eardrum may perforate (rupture) resulting in pus pouring into in the external ear canal (otorrhoea). The pain is often relieved when the drum bursts.
• Otitis media often presents a few days after the onset of a common cold or pharyngitis.