Walking pneumonia (also called atypical pneumonia) is a nonmedical term for a mild lung infection.
Unlike people with typical pneumonia, who may become severely ill, people with walking pneumonia can avoid hospitalization but may have to modify their daily routines and are likely to have some fairly uncomfortable symptoms.
Walking pneumonia can affect anyone, but it most often occurs among children between age 5 and 17 as well as young adults.
What Is Walking Pneumonia?
Walking pneumonia, like all forms of pneumonia, is an infection of tiny air sacs in the lungs called alveoli.
Alveoli take oxygen from the air and allow it to pass into the blood and travel to tissues throughout the body. Alveoli also remove carbon dioxide made by cells during normal metabolic processes and passed into the blood.
When microbes like bacteria invade the lungs, they can infect the alveoli, causing inflammation and swelling in the airways and alveoli.
Symptoms of walking pneumonia often resemble those of a chest cold, and can include:
While walking pneumonia can be caused by bacteria, viruses, or in some instances, mold, most cases are due to a type of bacteria called Mycoplasma pneumoniae (M. pneumoniae).
Less commonly, Chlamydophila pneumoniae can cause walking pneumonia, as can Legionella pneumophila bacteria (which can also cause a severe type of pneumonia known as Legionnaires' disease).
Viral infections, such influenza, COVID-19, and RSV, can also lead to walking pneumonia.
How Is Walking Pneumonia Different From Regular Pneumonia?
Walking pneumonia and typical pneumonia have different causes. While walking pneumonia is usually linked to Mycoplasma pneumoniae bacteria, typical pneumonia is usually associated with Streptococcus pneumoniae bacteria, Staphylococcus aureus bacteria, and certain viruses (such as those that cause COVID-19 and influenza).
Treatments for these forms of pneumonia differ since the microbes causing the illnesses are different, and the severity of the infections are very different.
While people with walking pneumonia may experience uncomfortable, cold-like symptoms, those with regular pneumonia might struggle to breathe, have intense coughing fits, see their heart rate shoot up, and spike a fever.
Walking pneumonia is very contagious, passing from one person to the next through tiny droplets that enter the air when coughing, sneezing, talking, or breathing.
A person with the infection can not only transmit the illness when symptoms appear, but also two to four weeks before any sign of sickness appears (the incubation period). Once symptoms do arrive, they can linger for weeks, during which a person can still remain contagious.
In many cases, symptoms are mild and get better on their own, so patients may not even bother to see a doctor for a diagnosis and treatment.
If the condition is aggravating enough, though, a person may end up at the doctor’s office or clinic. Healthcare providers will give a close physical exam, using a stethoscope to listen for crackling and other abnormal sounds in the lungs (auscultation).
Some healthcare providers will X-ray the lungs, and look for a patchy pattern that can indicate infection of the alveoli.
To confirm if a patient has walking pneumonia, a healthcare provider will take throat or nose swabs (or both) and send them out for lab testing to check for bacteria and viruses.
A healthcare provider may also order a Mycoplasma pneumoniae antibody blood test, although this is a less common means of diagnosis.
Walking pneumonia often goes away on its own. Patients are advised to get lots of rest, drink plenty of fluids, and take fever-reducing medicine if needed.
Antibiotics such as erythromycin, clarithromycin, or azithromycin (a class of drugs known as macrolides) can also help.
Some patients may benefit from a second-line antibiotic regimen (when other treatments aren’t working), such as fluoroquinolones or tetracyclines.
Certain viruses that can cause walking pneumonia, like the influenza virus, can be treated with antiviral medication. But for other viral infections there may be no specific treatment other than the standard advice to rest, stay hydrated, and take over-the-counter pain relievers.
As with many respiratory infections, the advice for steering clear of infection and preventing its spread is to:
Wash your hands often, especially after coughing or blowing your nose, going to the bathroom, and diapering, and before eating or preparing foods.
Cover your mouth with a tissue when you cough or sneeze.
Don’t smoke or drink alcohol. Smoking and alcohol can inhibit the body’s ability to fight off infection.
Maintain overall health. Stick with a healthy diet, rest, and get regular exercise.
Are There Vaccines for Walking Pneumonia?
While there are vaccines that can protect against typical pneumonia, there isn’t a vaccine that can prevent walking pneumonia.
Most people start to feel better within three to five days, but some symptoms can continue for weeks and a cough can linger for weeks or months.
Walking pneumonia can occasionally lead to severe and even life-threatening complications, such as:
Brain and nervous system infections, such as meningitis, myelitis (inflammation of spinal cord), and encephalitis (inflammation of the brain)
Severe lung damage
Hemolytic anemia, a condition in which there are not enough red blood cells in the blood because the body is destroying them
Respiratory failure requiring breathing machine support (ventilator)
If a person with walking pneumonia begins to have a very hard time breathing and is coughing up brown or bloody mucus, it’s time to get medical help.
Other symptoms that may warrant a medical visit include:
A very high fever
New symptoms, such as an earache, rash, or sore throat
Coughing that keeps you from resting or causes severe fatigue and chest pain
Walking pneumonia most often affects children and teenagers.
Symptoms are generally mild and usually get better on their own.
Because walking pneumonia is often a bacterial infection, antibiotics may help.
