It is not uncommon for a viral upper respiratory infection, such as a cold, to be present with a fever that lasts for 24 to 48 hours. Fever that occurs on day 3 or 4 of an upper respiratory infection may be caused by an ear infection. This is especially true if your child has other symptoms, such as fussiness, sleeplessness, or decreased appetite.

Fever may be a sign of an ear infection when:

• Other symptoms, such as ear discomfort, ear rubbing, or pulling at the ears, are severe or do not go away.
• Cold symptoms cleared up but other symptoms, such as fever and ear pain, are still present.