15744 Pneumonia Atypical Walking Pneumonia

Overview

Pneumonia is an infection of the lungs. Atypical pneumonia, sometimes called 'walking pneumonia,' is a milder form of the infection. It is usually caused by bacteria such as Mycoplasma pneumoniae. The symptoms can feel more like a bad cold or flu, and many people with walking pneumonia can still go about their daily activities, which is how it got its name.

Yes, atypical pneumonia is fairly common. Mycoplasma pneumoniae is one of the leading causes of pneumonia in school-age children and young adults. It often occurs in small outbreaks, for example in schools or military barracks.

It can affect anyone, but it is most common in children over 5, teenagers, and younger adults. People who live or work in close quarters, such as dormitories, schools, or nursing homes, have a higher chance of catching it.

Symptoms

Common symptoms

• Dry or hacking cough
• Low-grade fever (up to about 102°F or 39°C)
• Headache
• Tiredness or feeling run down
• Sore throat
• Chest discomfort or a feeling of congestion

Symptoms in children

• Cough that may be worse at night
• Mild fever
• Loss of appetite
• Feeling tired or cranky
• Sometimes ear pain or a runny nose

Symptoms in older adults

• Confusion or a change in thinking (may be the only sign)
• Lower body temperature than normal
• Weakness or a sudden decline in energy
• Difficulty breathing or rapid breathing
• A cough that may produce little or no phlegm

Causes

Main causes

• Bacteria called Mycoplasma pneumoniae (the most common cause)
• Other bacteria such as Chlamydia pneumoniae and Legionella pneumophila
• Viruses, such as the common cold or flu viruses, can also cause atypical pneumonia

Risk factors

• Being under age 5 or over age 65
• Living in crowded settings like schools, dorms, or nursing homes
• Having a weakened immune system
• Smoking or being around second-hand smoke
• Chronic lung conditions like asthma or COPD

When to see a doctor

See a doctor urgently if:

• Any of the emergency symptoms listed above — call your local emergency number
• Difficulty breathing, chest pain, or confusion

Book a routine appointment if:

• A persistent cough lasting more than 2 weeks
• A fever that lasts more than 3 days
• Worsening symptoms after an initial cold or flu
• Concern about your or your child's symptoms

Diagnosis

A doctor will ask about your symptoms and listen to your lungs with a stethoscope. Based on this, they may decide whether you have pneumonia. Sometimes they may order a chest X-ray or blood tests to confirm and rule out other conditions.

Tests that may be done

• Chest X-ray (if needed)
• Blood tests to look for signs of infection
• A mucus sample from a cough, if you are coughing up phlegm
• A pulse oximeter test to check oxygen levels in your blood

What to expect at your appointment

The appointment is usually straightforward. The doctor will ask about your symptoms and medical history, listen to your chest, and may check your temperature and oxygen levels. You may be asked to 'huff' cough or breathe deeply so they can hear your lungs more clearly. Most people do not need any special tests unless symptoms are severe or unusual.

Treatment

Treatment for walking pneumonia depends on the cause and how severe the illness is. Because it is often caused by bacteria, a doctor may recommend a course of antibiotics. However, not all pneumonia needs antibiotics, especially if a virus is the cause. The doctor will also advise on self-care measures to help you recover.

Self-care at home

• Rest as much as you need — do not push through
• Drink plenty of fluids to stay hydrated
• Use a cool-mist humidifier or take a warm bath to loosen mucus
• Avoid smoking and second-hand smoke
• Take over-the-counter pain or fever relief only if your doctor or pharmacist says it is appropriate for you

Medical treatments

Your doctor will recommend treatment based on the likely cause. If they think you have a bacterial infection, they will usually prescribe antibiotics. It is important to take the full course exactly as prescribed, even if you feel better. If a virus is the cause, antibiotics will not help — instead, the focus is on managing symptoms and letting the immune system fight the infection. In more severe cases, a doctor may suggest a short hospital stay for oxygen or intravenous fluids, but this is uncommon with walking pneumonia.

When is surgery considered?

Surgery is not used for pneumonia. This section is not applicable.

Living with this condition

Most people with walking pneumonia can manage at home. Rest is your main job. Take time off work or school while you are feverish and until your cough is improving. It may take several weeks to feel fully back to normal, even after the infection has cleared.

Lifestyle tips

• Stay home from work or school until your fever is gone and you feel well enough to return
• Avoid close contact with others to stop the infection spreading
• Wash your hands frequently or use hand sanitiser
• Cover your cough with a tissue or your elbow
• Get plenty of sleep and keep your bedtime regular

Diet and exercise

Eat nutritious meals and drink plenty of water, herbal tea, or soups. You do not need a special diet, but staying hydrated helps loosen mucus. Avoid heavy exercise while you are unwell. Once you feel better, start with gentle walks and increase activity gradually as your energy returns.

Mental health and emotional wellbeing

Being unwell for a week or more can be frustrating and make you feel low or irritable. It is normal to feel this way. Try to keep connected with friends and family by phone or video calls. If you feel very anxious or down for more than two weeks, talk to your doctor.

Prevention

You can reduce your risk by practicing good hand hygiene, covering coughs and sneezes, and staying away from people who are sick. Avoiding smoking and keeping your lungs healthy also helps.

Vaccines

There is no specific vaccine for walking pneumonia. However, there are vaccines against other causes of pneumonia, such as the pneumococcal vaccine and the flu vaccine. Your doctor or local health service can tell you which vaccines are recommended for your age and health.

Screening programmes

There is no routine screening test for walking pneumonia. If you have symptoms, see a doctor for an assessment.

Complications

If left untreated

• The infection can spread to other parts of the lung or cause a more serious pneumonia
• Some people may develop an ear infection, sinusitis, or a skin rash
• In rare cases, the infection can affect the nervous system or cause breathing failure
• People with weakened immune systems or asthma may have a harder time recovering

Long-term outlook

Most people with walking pneumonia recover fully within 2 to 4 weeks. Even without treatment, it often gets better on its own, but treatment can shorten the illness and reduce the chance of complications. Your doctor will help you through recovery, and there is very good reason for optimism.

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