The mucus sitting in the nose and chest during a cold is a breeding ground for bacteria. These bacteria normally live in the nose and throat in very small numbers. During the course of a cold, the bacteria will slowly build up over a period of 7 to 10 days. By this time, either the cold starts to resolve and all the mucus goes away, thus taking the bacteria with it, or the bacteria overgrow enough to take hold and cause what is called a secondary bacterial infection (the primary infection is the cold virus). This can occur in the sinuses, the chest, or the ears. This is why it is important to keep the nose and chest cleared out throughout the course of a cold. Be aware of these complications:
1. EAR INFECTIONS
Children may experience a feeling of plugged ears and mild ear pain. This occurs because the middle ear space behind the eardrum gets congested with mucus, just as the sinuses get congested with mucus. This can cause pressure and a plugged feeling that can hurt a little bit. When bacteria overgrow in this mucus, an ear infection flares up and becomes more painful. So if your child complains of occasional mild ear pain or a plugged feeling, it may not be an ear infection yet. If the pain is moderate to severe, have your doctor check it out. Infants, who are too young to report ear pain, will be unusually fussy, sleep and feed poorly, may or may not have a fever, and may pull on their ears. Keep in mind; if your infant is pulling on the ears, but is not very fussy and has no fever, then the ears probably are not infected yet. For more information on how to diagnose and treat ear infections see ear pain or ear infection.
2. SINUS INFECTIONS
This occurs when the bacteria in the sinus cavities around the nose build up enough to take over and cause an infection. Remember, this usually takes around 10 days of a cold to occur. Signs of a sinus infection include:
- Green nasal discharge for more than 10 days. Any green drainage before this is probably just due to the cold virus.
- Sinus headaches. Pain or severe pressure behind and around the eyes, forehead, and upper cheeks can be a sign of sinus infection. Remember, it is normal to have some headache at the beginning of a cold, or during the worst part of a cold. Green discharge from the eyes. If this is the only symptom, then it may be pink eye (or conjunctivitis). Eye drainage accompanied with all these other symptoms can mean sinus infection.
Dr. Sears suggests: Eye drainage during the course of a cold usually means a sinus infection and is a clue that a doctor should examine your child.
- Cough. The thick mucus produced during a sinus infection will drip down into the upper chest, thus causing a cough. A cough will almost always be present during a sinus infection. If your child does not have a cough, then there probably is no sinus infection.
- Fever. Infants and young children will usually have a fever during a sinus infection. Children older than 6 and adults may not have fever. Remember, fever can be normal for up to five days during a cold.
- Fatigue. Older children and adults will usually feel very worn out during a sinus infection. This fatigue can be part of a normal cold as well, but if it persists or is extreme, it could be the sinuses.
- Sinusitis face. Most children with a sinus infection have a “pekid” looking face, puffiness below the eyelids, hold their mouth open while breathing and have foul-smelling breath due to the snotty post-nasal drip.
If your child has the first symptom above (green nose for more than 10 days), plus three of the remaining symptoms, than it’s probably a sinus infection. Consult your doctor.
As stated above, this productive, junky cough is usually just part of the cold virus. The signs that your child may have bacterial bronchitis are junky sounding cough plus:
- Fever for more than 5 days and/or
- Chest pains, especially with coughing
- Rapid breathing
This occurs when bacteria overgrow in the mucus down in the lungs. That is why it is important to cough up this mucus. Here are the signs that your child’s cold and cough may have developed into pneumonia:
- Fever more than 5 days. Fever means a temperature over 101, not just 99 or 100 degrees. However, if your child has the remaining symptoms along with fever, consult your doctor. Most, but not all, children with bacterial pneumonia will spike temperatures over 102º.
- Shortness of breath. Signs of this include rapid breathing, labored breathing, moving the shoulders up and down to assist in breathing, or sucking in below the ribs or at the base of the neck.
- Chest pains. Your child will complain of a specific area of pain in the chest.
- Children with pneumonia act and look sick. If during the course of a cold your child “Takes a turn for the worse,” seek medical attention.
If you feel your child fits into any of the above four complications, you should see your doctor. Click here for more information on pneumonia.