8 Signs It's More Serious Than the Common Cold

You likely already know the signs of a cold—runny nose, congestion, sneezing, cough—but how do you know it's just a run-of-the-mill illness and not something more serious?

The common cold tends to clear up on its own in three to four days, said Melisa Lai Becker, MD, site chief of emergency medicine at Cambridge Health Alliance.

"With a cold, you ultimately feel OK after a couple days of rest, hydration, and Kleenex," Dr. Lai Becker said.

According to the Centers for Disease Control and Prevention (CDC), if symptoms last more than 10 days, you may have something more worrisome, such as the flu. To be safe, make an appointment with your healthcare provider.

You Recently Returned From a Big Trip

Recent international travel is a red flag for healthcare providers because it could mean you have a less-conventional infection they wouldn't have normally considered, explained Stella Safo, MD, an internist at Mount Sinai Hospital specializing in infectious diseases.

It's important to see a healthcare provider if you have any symptoms after returning from a trip abroad.

You Have a High Fever

The question of "Can you have a fever with a cold?" is tricky. While it's possible to be feverish when you have a cold, it's not common—especially high fevers.

If you have a fever at or above 101 degrees Fahrenheit, it could be a sign of strep throat, said Dr. Lai Becker. Most patients with strep will develop a high fever in the first few days of illness, so be wary of sudden spikes in your temperature.

"Strep throat is one thing you really want to distinguish from a cold," Dr. Lai Becker said. "Left untreated, it can cause rheumatic fever and lead to serious heart problems," said Dr. Lai Becker.

Strep throat is a bacterial infection that requires antibiotic treatment—it doesn't get better on its own the way a common viral cold does.

Additionally, strep throat generally doesn't cause symptoms like hoarseness (changes in your voice), runny nose, and cough, which are symptoms more commonly seen with a common viral cold, according to the CDC.

You've Had a Low-grade Fever for Days

Even if your fever isn't particularly high, running a low-grade fever for several days in a row could be a sign your body is trying to fight off more than a cold, said Dr. Lai Becker.

According to research published in the May 2022 issue of Frontiers in Medicine, a consistent fever could mean you have the flu or mono—so be diligent about checking it, even if it doesn't feel super intense.

You're Having Stomach Issues

Having nausea with a cold—as well as vomiting and diarrhea—isn't typical, so symptoms like these could signal something more serious, such as the flu.

It's important to get medical attention if you're experiencing these symptoms consistently, as they can cause you to become dehydrated, said Dr. Mysore.

You're Experiencing Chest Pain or Trouble Breathing

Even though a cough is a normal symptom of a cold, it shouldn't be so severe that it causes shortness of breath, wheezing, or chest pain, said Dr. Mysore. And according to the Frontiers in Medicine research article, these symptoms shouldn't be ignored since breathing trouble could be a sign of bronchitis or pneumonia.

At the same time, chest pain and sudden shortness of breath could signal a pulmonary embolism (a blood clot blockage in the lungs), according to Johns Hopkins Medicine.

Your Symptoms Are in One Location

Another red flag it's more than a cold is a "localization" of symptoms, meaning you feel them in one specific area, explained Dr. Safo. While cold symptoms affect the whole upper respiratory system, other illnesses are characterized by intense symptoms in one place.

For example, Dr. Lai Becker pointed out that strep causes a sore throat that makes swallowing difficult but typically won't cause pain throughout the body.

Sinus infections can cause headaches and even make your teeth hurt, an ear infection will usually cause pain and congestion in one ear, and mono can cause swollen tonsils.

You Have Body Aches

A regular cold is no walk in the park, but it shouldn't cause all-over body aches and pains. On the other hand, the flu can make your muscles and body feel achy and can also be accompanied by fatigue and chills.

"With the flu, you'll feel like you got hit by a truck," said Dr. Mysore. Getting out of bed will wear you out, and your muscles will be tender and sore.

There's a Pattern to Your Symptoms

It can be hard to distinguish allergies from colds since they have similar symptoms. But allergies will often follow a pattern, said Dr. Lai Becker. If you notice your symptoms are worse after spending time outside or with a pet, or they tend to come and go with a certain season, you likely have allergies.

"I had one patient who thought he was sick, but the real story was that he was allergic to a cat," Dr. Lai Becker said.

To pinpoint the exact cause, keep track of your symptom history and see if you notice any trends; it could mean you're allergic to something or have seasonal allergies.