Upper Respiratory Tract Infection (URTI): This is the most common cause of the symptoms described, including ear pain, cough, and congestion. The ear pain is often referred from the throat due to the common innervation of the throat and ear.

Acute Sinusitis: Sinus infections can cause congestion, cough, and referred pain to the ears due to the proximity of the sinuses to the ears and the shared drainage pathways.
Acute Otitis Media: An infection of the middle ear, which can cause ear pain and is often accompanied by symptoms of an upper respiratory infection like cough and congestion.
Acute Otitis Externa (Swimmer's Ear): An infection of the outer ear canal, which can cause ear pain and may be accompanied by cough and congestion if there is an associated upper respiratory infection.

Pneumonia: Although less likely, pneumonia can present with cough and congestion, and in severe cases, can cause referred ear pain. Missing this diagnosis could be life-threatening.
Peritonsillar Abscess: A complication of tonsillitis that can cause severe throat pain, which may radiate to the ear, and is accompanied by difficulty swallowing, fever, and potentially cough and congestion.
Lung Cancer: In rare cases, lung cancer can present with persistent cough and may cause referred pain, including ear pain, especially if there is involvement of the nerves.

Temporal Arteritis: An inflammation of the blood vessels in the head, which can cause ear pain and is often accompanied by other symptoms like headache and jaw claudication. It's rare but important to consider in older adults.
Ramsay Hunt Syndrome: A viral infection caused by the varicella-zoster virus that can lead to ear pain, facial weakness, and sometimes cough and congestion due to the involvement of the facial nerve.
Eustachian Tube Dysfunction: A condition where the tube that connects the middle ear to the back of the nose and throat doesn't open and close properly, leading to ear pain and potentially other symptoms if associated with an upper respiratory infection.