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Walking Pneumonia in Children : Symptoms, Causes, and Treatment

Getting to Know Pneumonia and Walking Pneumonia

Pneumonia is an inflammatory condition of the lungs typically caused by bacterial, viral, or fungal infections. It leads to the air sacs in the lungs filling with pus or other liquid, making it difficult to breathe. Symptoms often include coughing, fever, chest pain, and difficulty in breathing. Pneumonia is a prevalent childhood ailment, impacting between 150 to 156 million children below the age of five annually. In the United States, advanced medical treatments, including antibiotics, have significantly reduced its severity. However, in developing nations, pneumonia remains a substantial threat to children’s health.(1,2)

Among the various types of pneumonia, walking pneumonia is a common, relatively mild form observed in both children and adults. Typically, it does not necessitate hospitalization for children, and its symptoms are generally less severe compared to other types of pneumonia.

“Walking pneumonia,” also known as atypical pneumonia, is caused by the bacteria Mycoplasma pneumoniae. Unlike typical pneumonia, it tends to have less severe symptoms and people can usually continue their daily activities, which is why it is referred to as “walking.” However, it still requires medical attention and treatment to prevent complications and ensure a full recovery.(3) Let’s find out more about walking pneumonia in children.

What are the Symptoms of Walking Pneumonia?

Walking pneumonia, caused by the bacterium Mycoplasma pneumoniae, often presents with milder symptoms compared to other forms of pneumonia. The symptoms of walking pneumonia can closely resemble those of a common cold. Children, in particular, may not display typical signs of illness. They often maintain their usual eating and sleeping patterns, as well as regular bowel habits, making it harder to discern their condition.(4,5)

Common symptoms of this disease include:

  1. Persistent Cough: Walking pneumonia often starts with a persistent, dry cough that may worsen over time. This cough is typically the most prominent symptom and can linger for several weeks.
  2. Sore Throat: Some individuals with walking pneumonia may experience a mild to moderate sore throat. This discomfort is generally not as severe as in other types of respiratory infections.
  3. Low-Grade Fever: A mild increase in body temperature is common, typically ranging from 100.4°F to 102.2°F (38°C to 39°C). However, in some cases, there may be no fever at all.
  4. Fatigue: Generalized tiredness or a feeling of low energy is often reported. This fatigue can vary in intensity but is typically less severe compared to other forms of pneumonia.
  5. Headache: Mild to moderate headaches may occur, especially if the individual is experiencing fever or dehydration.
  6. Muscle Aches: Some individuals with walking pneumonia may experience mild muscle aches or discomfort. This is typically not as pronounced as in more severe cases of pneumonia.
  7. Chest Discomfort: There may be slight chest discomfort or a feeling of tightness, although it’s typically less severe compared to other types of pneumonia.
  8. Shortness of Breath: While less common in walking pneumonia, some individuals may experience mild shortness of breath, especially during physical activity or exertion.
  9. Nasal Congestion and Runny Nose: Mild congestion or a runny nose may be present, similar to symptoms of the common cold.

It is important to note that the severity and combination of symptoms can vary from person to person. Additionally, walking pneumonia symptoms can persist for several weeks if not properly treated.

What are the Causes of Walking Pneumonia?

Walking pneumonia, medically known as atypical pneumonia, is primarily caused by the bacterium Mycoplasma pneumoniae. Unlike other types of pneumonia, this bacterium lacks a rigid cell wall, which makes it resistant to certain antibiotics and gives it its “atypical” classification.

Here’s a detailed explanation of the potential causes of walking pneumonia in children:

  • Mycoplasma Pneumoniae Infection: This bacterium is the primary culprit behind walking pneumonia. It is highly contagious and is transmitted through respiratory droplets when an infected person coughs or sneezes. The tiny droplets containing the bacteria can be inhaled by individuals in close proximity.(6)
  • Person-to-Person Transmission: Close contact with an infected person, particularly in enclosed or crowded environments, increases the risk of contracting walking pneumonia. This is why outbreaks are not uncommon in places like schools, college campuses, and military barracks.(7)
  • Contaminated Surfaces: The bacterium can survive on surfaces for a limited period, ranging from a few minutes to a few hours. If a person touches a contaminated surface and then touches their face, especially the mouth, nose, or eyes, they can introduce the bacteria into their respiratory system.
  • Age and Immunity: While anyone can contract walking pneumonia, it is more frequently observed in children, adolescents, and young adults. This could be attributed to factors such as developing immune systems, increased social interactions, and shared living spaces.
  • Immune System Health: Individuals with weakened immune systems, such as those with chronic illnesses or taking immunosuppressive medications, may be more susceptible to Mycoplasma pneumoniae infection.
  • Existing Respiratory Conditions: People with pre-existing respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), may be at a higher risk of developing walking pneumonia and experiencing more severe symptoms.

Research indicates that pneumonia resulting from M. pneumoniae infection often follows a recurring pattern, with cycles typically spanning three to four years.(8) However, in certain regions, recent studies have shown a less frequent recurrence of these cycles.(9) Depending on your geographic location, you may observe increased instances of walking pneumonia every three to four years.

Seeking prompt medical attention and appropriate treatment is crucial for a full and speedy recovery.

How is Walking Pneumonia Treated?

Walking pneumonia in children is typically treated with antibiotics. However, it is important to note that Mycoplasma pneumoniae is resistant to some commonly used antibiotics, such as penicillin, and therefore, specific antibiotics effective against this bacterium are prescribed. Here is a detailed overview of the treatment for walking pneumonia:

Antibiotic Therapy:

  • Macrolides (e.g., Azithromycin): This is the first-line treatment for walking pneumonia caused by Mycoplasma pneumoniae. Azithromycin is commonly prescribed due to its effectiveness against this bacterium. (10)
  • Fluoroquinolones (e.g., Levofloxacin): In cases where macrolides are not suitable (e.g., allergies), fluoroquinolones may be used, especially in adults. (11)

Other treatment suggestions include:

  • Over-the-Counter Medications: Pain relievers like acetaminophen or ibuprofen can help alleviate fever and discomfort. Cough suppressants may also be recommended if the cough is severe.
  • Follow Medical Advice: It is important to complete the full course of prescribed antibiotics, even if symptoms improve before finishing the medication. Stopping antibiotics prematurely can lead to incomplete eradication of the bacteria, potentially causing a relapse.
  • Isolation and Hygiene: To prevent the spread of the infection, individuals with walking pneumonia should practice good respiratory hygiene. This includes covering the mouth and nose when coughing or sneezing, and disposing of tissues properly.
  • Follow-up Care: After completing the antibiotic course, it’s important to attend follow-up appointments with the healthcare provider to ensure the infection has been successfully treated and to address any lingering symptoms.
  • Inhaled Bronchodilators: In cases where there is significant bronchial constriction or wheezing, bronchodilator medications may be used to open the airways.
  • Hospitalization (in severe cases): While most cases of walking pneumonia can be managed on an outpatient basis, severe cases or individuals with underlying health conditions may require hospitalization for more intensive care.

It is crucial to consult a healthcare professional for proper diagnosis and treatment. They will prescribe the most appropriate antibiotics based on the specific strain of Mycoplasma pneumoniae, taking into consideration the individual’s age, allergies, and any existing medical conditions.


The prognosis for walking pneumonia in children is generally favorable. Rest remains a cornerstone of effective treatment, supplemented by antibiotics if prescribed by a doctor – ensuring the full course is completed is paramount. Since walking pneumonia can stem from various sources, it’s important to note the possibility of recurrence. Regular disinfection of frequently touched surfaces in the home can play a crucial role in preventing the spread of the illness. With proper care and precautions, children can recover well from walking pneumonia.


  1. Fritz, C.Q., Edwards, K.M., Self, W.H., Grijalva, C.G., Zhu, Y., Arnold, S.R., McCullers, J.A., Ampofo, K., Pavia, A.T., Wunderink, R.G. and Anderson, E.J., 2019. Prevalence, risk factors, and outcomes of bacteremic pneumonia in children. Pediatrics, 144(1).
  2. Regunath, H. and Oba, Y. (2021). Community-Acquired Pneumonia. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430749/.
  3. Bajantri, B., Toolsie, O., Venkatram, S. and Diaz-Fuentes, G., 2018. Mycoplasma pneumoniae pneumonia: walking pneumonia can cripple the susceptible. Journal of Clinical Medicine Research, 10(12), p.891.‌
  4. Lung.org. (2017). What Is Walking Pneumonia? [online] Available at: https://www.lung.org/blog/what-is-walking-pneumonia.
  5. Mount Sinai Health System. (n.d.). Atypical pneumonia Information | Mount Sinai – New York. [online] Available at: https://www.mountsinai.org/health-library/diseases-conditions/atypical-pneumonia.
  6. Hammerschlag, M.R., 2001. Mycoplasma pneumoniae infections. Current opinion in infectious diseases, 14(2), pp.181-186.
  7. Wohl, A.R., Simon, P., Hu, Y.W. and Duchin, J.S., 2002. The role of person-to-person transmission in an epidemiologic study of Pneumocystis carinii pneumonia. Aids, 16(13), pp.1821-1825.
  8. Youn, Y.S. and Lee, K.Y., 2012. Mycoplasma pneumoniae pneumonia in children. Korean journal of pediatrics, 55(2), p.42.
  9. Yew, P., Farren, D., Curran, T., Coyle, P.V., McCaughey, C. and McGarvey, L., 2012. Acute respiratory distress syndrome caused by Mycoplasma pneumoniae diagnosed by polymerase chain reaction. The Ulster Medical Journal, 81(1), p.28.
  10. Metersky, M.L., Ma, A., Houck, P.M. and Bratzler, D.W., 2007. Antibiotics for bacteremic pneumonia: improved outcomes with macrolides but not fluoroquinolones. Chest, 131(2), pp.466-473.
  11. Albertson, T.E., Dean, N.C., El Solh, A.A., Gotfried, M.H., Kaplan, C. and Niederman, M.S., 2010. Fluoroquinolones in the management of community‐acquired pneumonia. International journal of clinical practice, 64(3), pp.378-388.
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:September 22, 2023

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