"Colds" are caused by viruses and are often called URIs (upper respiratory infections) because they infect the nose, ears, and throat but not the lungs (lower respiratory tract). If your preschooler has a cold, she may have a runny nose with mucus that starts out clear but can turn thick and gray, yellow, or green over seven to ten days. She may also have a headache, sore throat, or cough.
Your child may also run a fever with a cold and with some minor viruses. With a cold it's likely to be a low-grade fever. With a minor virus it can even climb to 103 degrees Farenheit.
If your child has a fever with her cold, you'll notice that when the fever comes down she'll act much less sick than she will if something more serious is going on. A URI may cause your child to be irritable if her nose is stuffy or her throat hurts, but she'll still be playful at times and eat or drink (although perhaps slightly less than usual). On the other hand, if your child is dealing with something more serious than a cold — like pneumonia (a lung infection), a urinary tract infection, an ear infection, influenza, or meningitis — she won't improve very much when her temperature goes down.
The best rule to remember: It's appropriate for your child to be irritable or sleepy when her temperature rises to 103 degrees F, but it's not appropriate for her to act that way when her temperature drops toward normal. Serious infections usually have specific symptoms. She may feel more comfortable when the temperature comes down, but the infection is still present, so she'll still have body aches or an earache, or it will still hurt to breathe, or urinate, or move her head or neck, depending on the infection.
More serious illnesses are usually caused by bacteria (and some viruses) and are less likely to get better without medication. (Although some do get better. We know, for example, that many ear infections can get better without antibiotics, and the symptoms of strep throat also sometimes go away without treatment. But your child should be seen by a doctor if you're worried about an ear infection or strep throat.)
If you've decided that your preschooler has a cold, but her congestion lasts more than two weeks or she develops new symptoms— especially a new fever or irritability — it may mean that she has a new viral illness or bacterial infection, like an ear infection, sinusitis, or pneumonia. If so, it's time to have her checked out by the doctor.
Allergies can also cause a clear runny nose, itchy red eyes, scratchy throat, and a cough. Allergies themselves don't cause fevers. Children with allergies often get more colds, however, and seem to have more severe colds or colds that last longer. If your child gets frequent colds or is slow to clear a cold, or she continues to cough for a month or so after having a cold, her doctor will consider the possibility of allergies.
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