What Is Walking Pneumonia?

Medically Reviewed by Jabeen Begum, MD on March 19, 2024
Written by Joseph Saling, Kristin Mitchell
7 min read

Also known as atypical pneumonia, "walking pneumonia" is a mild form of pneumonia , which is a lung infection. It is common in children aged 5-15 years old and adults younger than 40. As the symptoms are similar to other respiratory infections, you could have walking pneumonia and not even know it.

Walking pneumonia vs. pneumonia

There are many kinds of pneumonia, and walking pneumonia is one of the least serious types. The symptoms are usually milder and don't require bedrest or a hospital visit. Walking pneumonia is usually diagnosed after a physical or an X-ray of the chest. In typical types of pneumonia, the X-ray would show one part of your lung that's affected. But if you have walking pneumonia, the X-ray will show the affected area as patches that are spread out.

Another difference between atypical pneumonia and pneumonia lies in their symptoms. With walking pneumonia, you may have a dry cough and a lower fever. With pneumonia, your fever could be higher (101-105 F) and your cough may have phlegm (filled with mucus).

About 5%-10% of cases of walking pneumonia turn into pneumonia.

Walking pneumonia is how some people describe a mild case of pneumonia. Your doctor might call it "atypical pneumonia" because it’s not like more serious cases.

A lung infection is often to blame. Lots of things can cause it, including:

  • Bacteria, including Mycoplasma pneumoniae and Chlamydia pneumoniae, which are common infections that can happen in crowded settings such as schools and places of long-term care
  • Viruses, including respiratory syncytial virus (RSV) and influenza virus, as both viruses can move from the upper respiratory tract to your lungs
  • Fungi (molds)

Walking pneumonia is usually caused by a bacteria called Mycoplasma pneumoniae, which can be hard to detect on a regular test for a bacterial infection (bacteria culture test).

Anyone can get it. Walking pneumonia from mycoplasma is most common in children, people involved in military training, and adults younger than 40.

People who live and work in crowded places -- such as schools, dorms, military barracks, and nursing homes -- are more likely to come into contact with it.

You're also more at risk for walking pneumonia if you have:

  • Chronic pulmonary disease (COPD)
  • Emphysema
  • A weakened immune system or take immunosuppressants such as those that treat autoimmune conditions
  • Asthma
  • Treatment with inhaled corticosteroids, such as cortisone or prednisone for the treatment of rheumatic conditions
  • A history of tobacco use
  • Had a previous lung condition or are in recovery from a respiratory infection

Late summer and fall are the most common times of year for walking pneumonia. But infections can happen throughout the year.

Walking pneumonia spreads through sneezes or coughs. But it spreads slowly. If you get it, you could be contagious (which means you could spread it to other people) for up to 10 days.

Researchers think it takes a lot of close contact with an infected person for a healthy person to catch walking pneumonia. Still, there are widespread outbreaks every 4-8 years.

Symptoms generally start 15-25 days after you’re exposed to mycoplasma and slowly get worse over 2-4 days. You might have:

Some people with walking pneumonia may also have an ear infection, anemia, or a skin rash. But others won’t have to stay in bed or the hospital and might even feel good enough to go to work and maintain a regular routine, having symptoms similar to those of a cold.

If you have a new cough, fever, or shortness of breath, call your doctor to talk about whether it might be COVID-19, the illness caused by the coronavirus.

Walking pneumonia symptoms in children

Walking pneumonia is the most common cause of pneumonia in children of school age. If your child has this type of pneumonia, symptoms can include:

  • Generally not feeling well
  • Tiredness
  • Headache
  • Fever
  • Dry cough that may progress
  • Ear or sinus infection
  • Sore throat
  • Croup
  • Skin rash

Some children who have airway conditions may develop wheezing. Symptoms can last 1 to 4 weeks.

To confirm whether you have walking pneumonia, your doctor may start with a physical exam, including listening to your chest for the sounds of your lungs. They may also ask about your symptoms and if you've been around anyone with similar symptoms. Your doctor might then order tests, including:

  • Chest X-ray
  • Mucus sample from the nose or throat
  • Blood test, which is the least common method of diagnosis

Many over-the-counter medicines for cold and flu may not ease all of your symptoms.

Your doctor might prescribe antibiotics if they think your infection is caused by bacteria. Medications include macrolide antibiotics (such as Zithromax or Biaxin) or tetracyclines (such as Emtet-500 or Acticlate), which can be used in adults and children, or fluoroquinolones (such as Cipro or Levaquin), which are usually only prescribed for adults.

They can help you recover faster if you start them early.

If you have walking pneumonia that was caused by a virus, you let it run its course; however, nonsteroidal anti-inflammatory drugs (NSAIDs) can help with fever and certain over- the-counter medications can help with cold-like symptoms such as mucus, congestion, and cough.

Tell your doctor about any other medicines you take or plan to take. Drink plenty of fluids and give yourself lots of time to rest. 

Although a cough can last weeks or months after treatment, you should start to feel better within 3 to 5 days. If you feel that you are recovering slower than expected or your symptoms get worse, talk to your doctor.

It’s possible. You might have some immunity for a while, but it's not clear how long it lasts. If you do get it again, it may be milder than the first time.

There’s no vaccine for mycoplasma infection, so you can’t completely prevent it. But you can take some steps to lower your chances of getting it:

  • Exercise, eat a well-balanced diet, and get enough sleep to keep your body healthy and better able to resist infection.
  • Wash your hands often. It’s one of the best ways to prevent germs from spreading.
  • Don't smoke. Smoking damages your lungs, and damaged lungs are more likely to get infected.
  • Cover your mouth with a tissue or your sleeve when you cough or sneeze. Ask others to do the same. Coughing and sneezing are the main ways that these infections are spread.
  • Get your flu shot every year.
  • Consider wearing a mask around those who are sick if you have a respiratory or chronic condition, which can put you at greater risk if you get walking pneumonia.

Walking pneumonia is a common infection that usually has mild symptoms that are similar to cold symptoms. If you have walking pneumonia, you may not have many symptoms and can treat the condition at home with over-the-counter medications, plenty of water, and rest. Talk to your doctor if you have symptoms, as they can prescribe certain medications that can speed up your recovery. Also, catching the condition early can prevent it from progressing to a more serious type of pneumonia.

What are the first signs of walking pneumonia? Some of the first signs of walking pneumonia include a cough, sore throat, fever, headache, and ear and chest pain. The cough that comes with the condition can continue for months.

What are the four stages of walking pneumonia? Stage I is congestion, during which you may have a cough and feel tired. Stage II is red hepatization, where red and white blood cells multiply due to the bacteria infection (your lungs become red). In Stage III, gray hepatization, the damage to your red blood cells causes your lungs to become gray in color. During Stage IV, the resolution stage, your airways improve and the inflammation in your fluid and damage to your cells goes away. This is the stage when you'll begin to feel better.

What happens if pneumonia is left untreated? For many people treatment is not needed; however, if your symptoms get worse or your recovery is slower, talk to your doctor. Walking pneumonia can turn into a more serious form of pneumonia.

Does walking pneumonia go away by itself? Walking pneumonia can go away without treatment, but it might take longer for your symptoms to go away. Your doctor can prescribe antibiotics to help you recover faster.