Purulent rhinitis, or nasopharyngitis, is a common outpatient problem in children, although the recommended course of action varies and includes all modalities from observation to antibiotics. This study compared complications and duration of illness between children with clear rhinorrhea and those with purulent rhinorrhea. Nasopharyngeal and throat cultures were compared between these groups and well children. No significant difference was found between rhinorrhea groups with respect to complications or duration of illness. Children with purulent rhinorrhea did have a significant higher level of middle ear pathogens (P less than .01) isolated from nasopharyngeal cultures. Observation with throat culture is the desired method of treatment.