Yellow? Green? What Does It Mean?
How can I tell the difference between a cold and a sinus infection? Is the color of the nasal discharge really that important? What can I do for my child to make him or her more comfortable? When should I take my child to the doctor? These are just some of the questions that parents often ask when their child is experiencing cold and sinus symptoms.
The symptoms of a common cold and a sinus infection can mirror each other and include nasal congestion, cough, sore throat and/or fever. While colds are caused by a viral infection and can be contagious, a sinus infection is usually a secondary infection that is related to a cold, is viral or bacterial in origin and is not contagious.
Home care measures for sinus symptoms focus on relieving nasal congestion, sinus pain and fever. Nasal congestion can be relieved through moisture. Spending 20 minutes in a steamy bathroom will loosen nasal discharge, and a cool mist humidifier in the room that your child sleeps in will help keep the air moist. Nasal washes, using one or two drops per nostril of normal saline and a bulb syringe, are also very helpful for removing dried mucous. Unless a sinus infection is related to diagnosed allergies, antihistamines are not recommended due to their effect of further thickening the nasal mucous. Sinus pain and pressure can be relieved with cold compresses and pain-reducing medications like acetaminophen or ibuprofen.
Worsening symptoms of fever, redness or swelling over sinuses, increasing sinus pain, or yellow or green nasal discharge lasting more than 10 to 14 days are indications that the sinuses have become infected. These symptoms will need to be evaluated by your child’s physician to determine if the sinus infection is viral or bacterial. If antibiotics are prescribed, it is important that the entire course of medication is completed to ensure that the infection is properly treated. Once antibiotics are started, your child should have relief of fever and sinus pain within 48 hours; if these symptoms persist or worsen after the initial 48 hours of antibiotic therapy, you will need to contact your child’s physician for consideration of another antibiotic to treat the sinus infection.
Because sinus infections are usually secondary to colds, prevention measures should focus on the reduction of colds. Good hand-washing is the first line of defense in reducing your child’s exposure to viral infections. Teaching children how to blow their nose to clear nasal discharge will help keep sinuses open so they can drain adequately. Lastly, the importance of immunizations can not be stressed enough. Specifically, the Hib, pneumococcal and measles vaccines (which are included in the recommended childhood vaccination schedule) and an annual influenza vaccine will protect your child from these serious illnesses, as well as potential sinus infections.
If you are unsure of the severity of your child’s symptoms, recommended home care measures, or whether evaluation is necessary, it is safest to err on the side of caution and consult with your child’s physician.
This article was written by Kit Schmitz, RN, Answer Line nurse at St. Louis Children’s Hospital. For more information, call 314.454.KIDS (5437) or 800.678.KIDS.


