WHEN IS A COLD "NOT A COLD"

The average child gets between 5 and 7 viral upper respiratory infections yearly. The majority occur during the cold weather seasons. A viral "cold" is not treated with antibiotics, but must run its own course. Typically, the time course of an upper respiratory virus syndrome is about 5-7 days. The symptoms can be quite severe, with runny nose, sore throat, cough, and fevers variably present. Our general approach to a child with a viral illness is supportive. TLC, acetamenophen (tylenol) for fevers, saline nasal washes, humidification, and time are usually sufficient "treatment" in otherwise healthy children. If the symptoms are severe enough (e.g. high fevers, shortness of breath, listlessness, prolonged poor oral intake) a good medical evaluation is in order. A sinus infection is usually caused by a bacteria and typically requires antibiotic treatment. In my practice, the most reliable indicator is the duration of symptoms. If cold-like symptoms persist for more than the typical 5-7 days, bacterial sinusitis has to be considered. The color of the discharge is very non-specific and can be discolored in both virus and bacterial nasal infections.  As you can probably see, it is not always easy to differentiate a cold from a sinus infection.  When in doubt, ask you healthcare provider.