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Cold, Flu, & Cough Health Center

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Is Your Earache Just a Cold or an Ear Infection?

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Is your earache from a cold or ear infection? WebMD explains how to tell the difference.

What Is the Difference Between the Symptoms of a Cold and an Ear Infection?

An earache from a cold can be a sharp, dull, or burning pain that can range from mild to very painful. Even if the trapped fluid in the ear is not infected, the fluid puts pressure on the eardrum, causing it to bulge and throb.

With an earache from a cold, you or your child may have difficulty sleeping, run a fever, and have green or yellow mucus in the nose. Because colds are self-limiting, an earache with a cold usually goes away on its own. Still, if you have an earache, you might need to see your doctor for a diagnosis and proper treatment.

While earaches can occur first with a cold virus, sometimes a secondary infection of the middle ear may occur. These ear infections are usually sudden in onset and extremely painful in the beginning. That's because the sensory nerve endings in the eardrum respond to increased pressure with pain. After the eardrum stretches a little, the earache pain may ease up.

Other symptoms of an ear infection, or otitis media, may include the following:

  • Loss of appetite. This may be apparent in young children, especially during bottle feedings. Pressure changes in the middle ear as the child swallows, causing more pain.
  • Irritability.
  • Poor sleep. Pain may be more persistent when lying down as fluid is shifting.
  • Fever. Ear infections can cause temperatures up to 104 degrees F.
  • Vertigo . You may have a sense of spinning.
  • Drainage from the ear. Yellow, brown, bloody, or white fluid that isn't earwax may seep from the ear, indicating the eardrum may have ruptured.
  • Difficulty hearing. Fluid build-up in the middle ear prevents the eardrum from functioning properly. The sound is then unable to be transmitted to the bones of the middle ear and from there to the brain.
  • Otitis media with effusion. Symptoms of acute otitis media will disappear, but the fluid, which is called an effusion, may remain. Trapped fluid causes temporary and mild hearing loss.
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