Atypical (Walking) Pneumonia

What is walking pneumonia?

Walking pneumonia is a mild form of pneumonia. Pneumonia is a lung infection that causes your airways to swell, the air sacs in your lungs to fill with mucus and other fluids, a high fever and a cough with mucus. If you have walking pneumonia, you may feel well enough to walk around and carry out daily tasks without realizing you have pneumonia.

“Walking pneumonia” is the common term for atypical pneumonia.

How is walking pneumonia different from “regular” pneumonia?

The main differences between walking pneumonia and “regular” pneumonia are that walking pneumonia is milder and it usually doesn’t require bed rest or hospitalization.

Who does walking pneumonia affect?

Anyone can get walking pneumonia. You’re more likely to get walking pneumonia if you:

• Are 2 or younger.
• Are 65 or older.
• Have a weakened immune system (immunocompromised) or take immunosuppressant medications.
• Have chronic obstructive pulmonary disease (COPD).
• Have asthma.
• Have emphysema.
• Live or work in crowded places, such as schools, dormitories, nursing homes or military barracks.
• Use tobacco products.
• Regularly use inhaled corticosteroids.

How common is walking pneumonia?

Walking pneumonia is common. The number of cases fluctuates, usually spiking every three to seven years.

Walking pneumonia can occur at any time of the year. However, it occurs most often during the fall and winter.

What are the first signs of walking pneumonia?

Walking pneumonia symptoms include:

• Sore throat (pharyngitis).
• Extreme tiredness (fatigue).
• Chest pain or discomfort.
• Low-grade fever (less than 101 degrees Fahrenheit or 38 degrees Celsius).
• Mild chills.
• Cough.
• Sneezing.
• Headache.

What does walking pneumonia feel like?

Walking pneumonia may feel like you have a bad cold or the flu.

What causes walking pneumonia?

Walking pneumonia causes may include:

• Bacteria.
• Viruses.
• Molds (fungi).

Is walking pneumonia contagious?

Yes, walking pneumonia is very contagious. When someone who has walking pneumonia coughs, sneezes, talks, sings or breathes near you, tiny droplets containing the disease enter the air. The illness spreads if you inhale those droplets.

How long am I contagious if I have walking pneumonia?

If you have walking pneumonia, you’re contagious for two to four weeks before symptoms appear (incubation period).

During the incubation period, you probably won’t realize you’re contagious and spreading walking pneumonia. Once the symptoms start, you’re contagious until the symptoms end.

How is walking pneumonia diagnosed?

A healthcare provider can diagnose walking pneumonia. They’ll conduct a physical examination and perform auscultation. They’ll ask about your symptoms, including how long you’ve had them. They may also ask whether any family, friends, coworkers or other people you regularly interact with are sick with similar symptoms.

During auscultation, the provider will use a stethoscope to listen to your lungs. A stethoscope is a medical device with a small, metal disc (diaphragm) that connects to earpieces with rubber tubing. They’ll press the diaphragm against your chest and back and listen for abnormal sounds.

If the provider suspects you have walking pneumonia, they’ll order tests to help confirm their diagnosis.

How do healthcare providers test for walking pneumonia?

A healthcare provider may order chest X-rays to see if there’s an infection in your lungs. They may also take a mucus sample or conduct blood tests to determine the cause of your walking pneumonia.

During a blood test, the provider will use a thin needle (21 gauge, slightly smaller than the size of a standard earring) to withdraw a small amount of blood from a vein in your arm. They’ll send the sample to a laboratory.

A blood test usually isn’t painful, but you’ll feel a slight pinch as the needle goes into your skin.

How is walking pneumonia treated?

Walking pneumonia treatment depends on its cause.

If a healthcare provider suspects that you have walking pneumonia and its cause is bacteria, they may prescribe antibiotics. They may prescribe the following:

• Macrolide antibiotics. Macrolide drugs include azithromycin (Zithromax®) and clarithromycin (Biaxin®). They’re appropriate for children and adults.
• Fluoroquinolones. Fluoroquinolones include ciprofloxacin (Cipro®) and levofloxacin (Levaquin®). Providers usually don’t prescribe fluoroquinolones to young children.
• Tetracyclines. Tetracyclines include doxycycline (Acticlate®) and tetracycline (Emtet-500®). They’re appropriate for adults and older children.

If a provider prescribes antibiotics, be sure to finish the full course, even if you feel better. If you don’t, walking pneumonia may come back and be more difficult to treat.

If you have walking pneumonia as a result of a virus or another cause, you have to let the illness run its course.

A provider may recommend over-the-counter (OTC) medications to help relieve nasal congestion, cough and mucus buildup in your chest. You can help open your airways by drinking plenty of warm fluids, using a humidifier or taking a hot bath or shower.

If you have a fever, it’s a good idea to drink more fluids and rest. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also help reduce your fever. Not everyone can take NSAIDs, so it’s a good idea to check with a provider before you take them.

Walking pneumonia is usually mild and doesn’t require hospitalization.

Will walking pneumonia go away without antibiotics?

Some cases of walking pneumonia may go away without antibiotics. However, it may take longer to feel better. Talk to a healthcare provider if you have any concerns about taking antibiotics.

What happens if walking pneumonia is left untreated?

Walking pneumonia is mild and can usually go away on its own without treatment. However, if you have walking pneumonia symptoms, a healthcare provider is the best person to help you determine the appropriate treatment.

How long does walking pneumonia usually last?

Walking pneumonia may last from four to six weeks. A cough is usually the longest-lasting walking pneumonia symptom.

How can I prevent walking pneumonia?

Unfortunately, there aren’t any vaccines available that prevent walking pneumonia. You can get walking pneumonia more than once.

The following tips can help you prevent walking pneumonia:

• 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 your sleeve. Place used tissues into a waste basket. Don’t sneeze or cough into your hands.
• Regularly wash your hands with soap and clean water for at least 20 seconds. If soap and clean water aren’t available, use an alcohol-based hand sanitizer.
• Wear a mask around sick people if you have a respiratory condition (e.g., asthma, bronchitis or emphysema) or other chronic health conditions (e.g., diabetes or heart, liver or kidney diseases). These conditions can make walking pneumonia riskier for you.
• Get an annual flu shot.
• Don’t smoke, and don’t allow others to smoke around you. Smoke can make your symptoms worse.

What can I expect if I have walking pneumonia?

The outlook for most people who have walking pneumonia is good. Many people start to feel better after a few days on antibiotics and rest. However, a cough may continue for weeks or even months.

When should I see a healthcare provider?

See a healthcare provider if your symptoms don’t improve after several days of antibiotics. They may prescribe a different antibiotic or encourage you to rest and take medications to help relieve your symptoms.

It’s also important to be safe with your medicines. Take them exactly as prescribed or recommended by a healthcare provider. Ask a provider before you take multiple medications at the same time, especially pain medications.

What questions should I ask a healthcare provider?

• How do you know I have walking pneumonia?
• If I don’t have walking pneumonia, what other condition might I have?
• How did I get walking pneumonia?
• What kind of treatment do you recommend?
• For how long and at what times of day should I take antibiotics?
• How should I store my antibiotics?
• Do I need to schedule a follow-up appointment?

What is the difference between walking pneumonia and pneumonia?

Walking pneumonia is a milder form of pneumonia.

Their symptoms are similar, but walking pneumonia has a low fever and a cough that doesn’t produce phlegm (dry cough). Pneumonia has a higher fever (101 to 105 degrees F, or 38 to 40 degrees C) and a cough that produces phlegm (wet or productive cough).

If you have pneumonia, you may require several days of bed rest or even hospitalization. Walking pneumonia feels like a bad cold or the flu.

What is the difference between walking pneumonia and COVID-19?

COVID-19 is a respiratory illness. The coronavirus SARS-CoV-2 causes COVID-19. It spreads through respiratory droplets in the air and shares many of the same symptoms as walking pneumonia. However, it may also cause muscle and body aches, loss of taste or smell, diarrhea and nausea and vomiting.

Walking pneumonia is also a respiratory illness. However, the most common cause of walking pneumonia is a type of bacteria, not a virus.

A note from Cleveland Clinic

Walking pneumonia is a common respiratory infection that many people mistake for a bad cold or the flu. Because of this, many people don’t seek treatment. You can manage many of your symptoms with over-the-counter medications, rest and plenty of fluids. Still, it’s a good idea to see a healthcare provider if you have signs of walking pneumonia, even if you think it’s just a cold or the flu. They can prescribe antibiotics that can help speed up your recovery. They can also answer any of your questions or concerns.