• Ear pain
• Irritability
• Full sensation in the ear
• Fever
• Drainage
• Pulling at the ear in small children (direct correlation between pulling at the ears and infection is uncertain)

Patient will be referred to primary care provider if:

• If fever is over 103 degrees
• Fever with toxic appearance
• Listlessness
• Unable to eat or drink
• Stiff neck with severe pain
• Significant dizziness
• More than 3 visits in past 6 months for ear infection
• Have an immunocompromised condition