Atypical (Walking) Pneumonia

Overview

What is “walking” pneumonia?

“Walking” pneumonia is a mild form of pneumonia (an infection of the lungs). This non-medical term has become a popular description because you may feel well enough to be walking around, carrying out your daily tasks and not even realize you have pneumonia.

Most of the time, walking pneumonia is caused by an atypical bacteria called Mycoplasma pneumoniae, which can live and grow in the nose, throat, windpipe (trachea) and lungs (your respiratory tract). It can be treated with antibiotics.

Scientists call walking pneumonia caused by mycoplasma “atypical” because of the unique features of the bacteria itself. Several factors that make it atypical include:

  • Milder symptoms
  • Natural resistance to medicines that would normally treat bacterial infections
  • Often mistaken for a virus because they lack the typical cell structure of other bacteria

Are there other types of atypical pneumonias?

Yes. Other types of atypical pneumonia include:

How is walking pneumonia different from “regular” pneumonia?

Walking pneumonia differs from typical pneumonia in several ways, including:

  • Walking pneumonia is a milder form of pneumonia.
  • Walking pneumonia usually does not require bed rest or hospitalization.
  • Walking pneumonia is usually caused by Mycoplasma pneumoniae. Typical pneumonia is most commonly caused by _Streptococcus _pneumonia or influenza (flu) virus or rhinovirus.

How common is walking pneumonia?

Mycoplasma pneumoniae accounts for 10 to 40 percent of the cases of community-acquired pneumonia (pneumonia contracted outside a healthcare setting).

Walking pneumonia can occur at any time of the year although it occurs most often in the fall and winter.

Is walking pneumonia contagious? If so, how is it spread and who is most at risk?

Yes, walking pneumonia caused by Mycoplasma pneumoniae is contagious (spread through person-to-person contact). When an infected person coughs or sneezes, tiny droplets containing the bacteria become airborne and can be inhaled by others who are nearby.

The infection can be easily spread in crowded or shared living spaces such as homes, schools, dormitories and nursing homes. It tends to affect younger adults and school-aged children more than older adults.

The risk of getting more severe pneumonia is even higher among those who have existing respiratory conditions such as:

How long am I contagious with walking pneumonia?

If you have walking pneumonia caused by Mycoplasma pneumoniae, you can be considered contagious from two to up to four weeks before symptoms appear (called the incubation period). During this time, you will not realize you are contagious and spreading pneumonia. Once the symptoms start, you remain contagious until the symptoms end.

Symptoms and Causes

What causes walking pneumonia?

Walking pneumonia is most commonly caused by Mycoplasma pneumoniae bacteria.

What are the symptoms of walking pneumonia?

Symptoms of walking pneumonia include:

  • Sore throat (pharyngitis)
  • Feeling tired (fatigue)
  • Chest pain
  • Mild chills
  • Low-grade fever
  • Persistent cough that can be dry or produce mucus
  • Sneezing
  • Headache

The symptoms of walking pneumonia may come on slowly, beginning one to four weeks after exposure. During the later stages of the illness, symptoms may worsen, the fever may become higher, and coughing may bring up discolored phlegm (mucus).

Diagnosis and Tests

How is walking pneumonia diagnosed?

Your doctor will ask you about your symptoms, how long you’ve had them and if any other family members or people you regularly interact with are also ill with similar symptoms. He or she will listen to your lungs with a stethoscope to check for abnormal breath sounds. Your doctor may order chest X-rays to see if there is an infection in your lungs. Your blood or mucus might be tested to determine if your pneumonia is caused by Mycoplasma pneumoniae, another bacteria, virus or fungus.

Management and Treatment

How is walking pneumonia treated?

Walking pneumonia is usually mild, does not require hospitalization and is treated with antibiotics (if your doctor thinks bacteria is causing your symptoms). Several types of antibiotics are effective. Antibiotics that are used to treat walking pneumonia caused by Mycoplasma pneumoniae include:

  • Macrolide antibiotics: Macrolide drugs are the preferred treatment for children and adults. Macrolides include azithromycin (Zithromax®) and clarithromycin (Biaxin®). Over the past decade, some strains of Mycoplasma pneumoniae have become resistant to macrolide antibiotics, possibly due to the widespread use of azithromycin to treat various illnesses.
  • Fluoroquinolones: These drugs include ciprofloxacin (Cipro®) and levofloxacin (Levaquin®). Fluoroquinolones are not recommended for young children.
  • Tetracyclines: This group includes doxycycline and tetracycline. They are suitable for adults and older children.

Often, over-the-counter medications can also be taken to help relieve symptoms of nasal congestion, cough and loosen mucus buildup in the chest. If you have a fever:

  • Drink more fluids
  • Rest
  • Take medicine

Prevention

How can walking pneumonia be prevented?

Unfortunately, no vaccines are available to prevent walking pneumonia caused by Mycoplasma pneumoniae. Even if you have recovered from walking pneumonia, you will not become immune, so it is possible to become infected again in the future.

Tips for preventing walking pneumonia include:

  • Cover your nose and mouth with a tissue when you sneeze or cough. If a tissue isn’t available, sneeze or cough into the inside of your elbow or sleeve. Never sneeze or cough into your hands. Place used tissues into a waste basket.
  • Wash your hands often with warm water and soap for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
  • Wear a mask around sick people if you have respiratory conditions (such as asthma, bronchitis, emphysema) or other chronic health conditions (heart, liver or kidney diseases, or diabetes) that would make getting pneumonia even riskier for you.
  • Get your annual Influenza (flu) shot. Bacterial pneumonia can develop after a case of the flu.
  • Ask your doctor about the pneumococcal vaccine. Two types of vaccines are available, Prevnar 13® and Pneumovax 23®. Each vaccine is recommended for people at different age points or who are at increased risk for pneumococcal disease, including pneumonia.

Outlook / Prognosis

When will I start feeling better if I have walking pneumonia?

Most people with walking pneumonia will feel better after a few days on antibiotics. Your cough might continue for a few weeks.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy