- Signs of infection of the ears (pain, children will scratch at their ears)
- Chest pain, wheezing or shortness of breath
- Fever above 39.4°C (104°F) that cannot be lowered
- Fever lasting beyond 5 days or goes away, but returns
- Severe sinus pain, headache or sore throat
- Nasal discharge or sinus pain persisting beyond 10 days
- Cold symptoms do not improve or continue to worsen after 10 days