12 Signs Your Common Cold Could Be Something Worse

Updated: Oct. 11, 2022

Here's how to tell the difference between a cold, or upper respiratory infection, and bronchitis, the flu, or even pneumonia.

It’s not the usual symptoms

Anyone who says “it’s just a cold” is forgetting exactly how miserable the viruses can be: Runny nose, sore throat, headaches, fatigue, sneezes—and those are just a few of the unpleasant symptoms, explains Mylynda Massart, MD, PhD, a family medicine physician at the University of Pittsburgh Medical Center (UPMC). Every year, one billion colds strike people in the United States—which means some of us are getting two to three a year—and some of those colds can actually be something worse. Read up on the common cold symptoms you probably never knew about.

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Your whole body aches

Sussing out the difference between a cold and the flu is tricky. A cold hangs out in your head or chest, says Renee Miranda, MD, family medicine doctor with Lonesome Pine Hospital in Big Stone Gap, Virginia. If your symptoms include whole body aches and pains, it may be the flu, which is caused by an influenza virus. If you can see a doctor within two days of being infected, she can prescribe an antiviral medication to help clear the virus, says Dr. Massart. There are four approved antiviral drugs for the flu, according to the Centers for Disease Control and Prevention (CDC). The medications are generally recommended for those at high risk for complications—your immune system is compromised (due to cancer treatment or HIV/AIDS infection, for example), or you’re very young or old. People who get a relatively mild case of the flu and are otherwise healthy can take one of the drugs (one example is oseltamivir, or Tamiflu) but generally don’t need an antiviral medication, according to the CDC. (Remember that the flu is a virus, and an antibiotic absolutely will not work.) Try these 21 natural cold remedies that may help ease symptoms.

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Your throat is on fire

It’s normal to have an itchy, scratchy throat when you have a cold, but if you have a higher fever with swollen lymph nodes and severe soreness in your throat that comes on quickly, it may be strep, notes Dr. Miranda. “Your doctor has to do a swab test to identify strep,” she says. Because strep is caused by bacteria, your doctor may prescribe antibiotics if the test is positive.

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Suddenly, one ear is in pain

Picture this: You assumed you had a cold. (You were right!) And you started to get better only to suddenly feel a throbbing pain in your ear—and it’s hard to hear, too. Your cold could have morphed into an ear infection. “We have all this extra mucus and phlegm in our ears, throat, and lungs, making for a great place for bacteria to jump in and set up camp, causing a secondary infection, like an ear infection,” says Dr. Massart. Don’t miss these habits doctors follow to avoid colds and the flu.

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Your cold won’t go away

A cold peaks during days two and three. “By days five to seven, the symptoms should start to subside,” says Dr. Miranda. By seven to ten days, you should feel better. If you feel the same or worse, you may have something different, like sinusitis. This condition begins as a cold, but then can turn into a bacterial infection that inflames your sinuses. However, Dr. Massart points out that symptoms have to stick around for more than 14 days to be a true sinus infection, and only at that point will docs consider antibiotics. These are the clear signs you have a sinus infection.

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Your cough can’t quit you

The hacking just won’t stop: You might have bronchitis, an inflammation of the lungs that can set you up with a cough that lasts five to six weeks, says Dr. Massart. In this case, rest and hydration are necessary. “Most of the time bronchitis is viral. You won’t need antibiotics, and it’ll take time to fight off the infection,” she says. (Read how this man’s chest congestion turned out to be a heart attack.)

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You’re throwing up

This one may seem obvious, but if you have a cold, you shouldn’t be running to the bathroom to vomit (or because of diarrhea). What many people describe as the “stomach flu” is more accurately called gastroenteritis. “The real flu doesn’t affect the stomach at all,” says Dr. Massart. The most important step is staying adequately hydrated. You should start to feel better after 24 hours. Here are 10 winter foods you should eat to avoid the flu.

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You have bloody diarrhea

Again, this would seem like a clear indication that you don’t have a run-of-the-mill cold, but being sick isn’t always so cut-and-dry. If you’ve been ill and have had diarrhea to go along with it, watch out for bloody diarrhea, says Dr. Massart. That’s a sign that you may have food poisoning rather than a viral infection, such as gastroenteritis. “Most of the time your body will fight off food poisoning, but once in a while you’ll need more help,” she says. In this case, call your doctor.

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You’re wheezing and short of breath

People diagnosed with an inflammatory lung condition called COPD (chronic obstructive pulmonary disease) need to be especially wary of catching a cold because this can become a more serious upper respiratory infection—especially in the elderly. “If grandma has COPD and catches a cold, it can land her in the hospital,” says Dr. Massart. For everyone, it’s important to be aware of friends and loved ones with COPD and limit contact with them when you’re sick, she says. Don’t miss this DIY flu-fighting kit.

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You always get sick right about now

Some patients will tell Dr. Massart that they get a cold that lasts two to three months every winter. “That’s actually chronic bronchitis, which is a precursor to COPD,” she says. If that sounds like you, especially if you have risk factors for COPD (are a long-term smoker, for instance), talk to your doctor. Find out the best medications for cold and flu on the market.

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You’re having a heck of a time breathing

Do you have asthma? A cold can trigger an asthma attack. One sign that your breathing difficulties are related to asthma and not a cold is that your asthma meds are no help, says the Mayo Clinic. If you can’t control your symptoms, it’s important to talk to your doctor to determine what treatment plan is right for you during cold season. Here’s some flu season etiquette you need to know.

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The cough is deep in your chest

A bad cough sounds bad, but there are degrees of bad: “A cold is in your nasal and throat area, not deep in your lungs,” says Dr. Miranda. If the cough is in your chest, there’s a chance it can be pneumonia. Signs include chest pain with breathing or coughing, nausea, vomiting, or diarrhea. Your doctor will need to listen to your lungs to make the right diagnosis.

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Your colds are predictable

Another possibility: You have allergies. Symptoms can be very similar, such as sneezing and a nose that runs like a faucet. But if you can predict almost to moment when you’re going to feel under the weather, that’s more of an indication of allergies. “Patients will say ‘it seems like when I go to so-and-so’s house, I cough, get itchy eyes, and a runny nose’,” explains Dr. Miranda. Over-the-counter antihistamines may do the trick.

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Think cold first

It’s called the common cold for a reason. “Most of the time, it is just a cold,” says Dr. Massart. Don’t assume that a sore throat is strep or a headache means you have a sinus infection. “The risk is thinking that you automatically need antibiotics when that’s not the case,” she says. You also can’t take antivirals for a cold. Next, find out what doctors and nurses do to stop a cold in its tracks.