How to tell if your child has a cold or a sinus infection

Does your child have a viral illness such as the common cold or a bacterial illness known as a sinus infection?

Both can appear similar in their initial stages, but a viral illness will get better on its own. A sinus infection will likely need a doctor’s intervention for your child to get better. Here are some guidelines to help you figure out how to tell the difference between the two and when your child may need to see their pediatrician.

Length of illness

Viral infections tend to last 5 to 10 days with symptoms peaking at 3-5 days, whereas a bacterial infection can persist for greater than 10 days without showing signs of improvement.

Fever

Fevers due to a viral illness start at the onset of the illness and dissipate usually within 3 days of onset. Fevers due to a bacterial illness will often last longer than 4 to 5 consecutive days.

Nasal discharge

Both illnesses can have nasal discharge with mucus going from clear to colored, however mucus from a virus will often return to clear. A bacterial illness usually will have mucus that will remain colored and pus-like.  

Other symptoms

Both can be accompanied by a cough, but bacterial infections can have a more prolonged course with development of other symptoms such as worsening headaches, vomiting or fatigue.

Don’t assume all illnesses require an antibiotic, since these are only helpful if a child has a bacterial infection. If in doubt, visit your child's pediatrician; they can help you sort it out.