Could You Have Walking Pneumonia? Here's How to Tell

Hint: You may not even feel that bad.

Walking pneumonia is a milder form of pneumonia that doesn’t knock you off your feet or send you to the hospital—or even home to bed.

“It means that people aren’t very sick,” Cedric “Jamie” Rutland, MD, a spokesperson for the American Lung Association, told Health. “The cough might last six weeks, but people can still go to work, go to school, do their thing.”

Walking Pneumonia Overview

Some people with walking pneumonia don’t even realize they’re sick. Those who do suspect they're sick often don’t think they have something as serious-sounding as pneumonia (which, by definition, means an infection in your lungs).

Walking pneumonia (also called atypical or mycoplasma pneumonia) is often confused with other respiratory conditions including bronchitis, the flu, and the common cold.

There are some characteristics, though, that help distinguish this type of pneumonia from other conditions, including its more severe cousins.

“Walking pneumonia is usually spread in the late summer and early fall,” said Dr. Rutland, who is also an assistant clinical professor at the University of California, Riverside School of Medicine.

Other respiratory illnesses tend to peak when, for example, everyone is clustered together indoors. Walking pneumonia also commonly affects children, who might then bring it home and pass it to other family members during school-based outbreaks.

Causes and Risk Factors

Walking pneumonia is caused by viruses or bacteria. Most often, the culprit is a type of tiny bacteria called Mycoplasma pneumoniae. Mycoplasma pneumoniae is widespread and can infect people younger than 40 years old as well as the elderly, especially those living and working in crowded conditions.

Additionally, pneumonia in any form (not to mention bronchitis, colds, and the flu) is easily transmissible through coughing and sneezing.

Bacterial pneumonia can occur on its own or develop after you've had a viral cold or the flu. Those at greatest risk for bacterial pneumonia include people recovering from surgery, people with respiratory disease or viral infection, and people who have weakened immune systems.

Signs and Symptoms

Coughing up a mix of mucus and saliva (aka sputum) can be a tip-off that you have pneumonia of some kind.

“A cough with yellow, green, brown, or bloody sputum can be a sign that it is pneumonia, but it is not always a conclusive sign,” Susanna Von Essen, MD, professor of pulmonary medicine at the University of Nebraska Medical Center in Omaha, told Health. That cough may last several weeks, well after the infection itself is gone.

A fever is also an important clue—especially one over 100 or 101 degrees—that your symptoms are from pneumonia, said Dr. Von Essen. Then again, “some of the sickest [pneumonia] patients do not have a fever at all,” added Dr. Von Essen. The flu can also come with a fever.

Other walking pneumonia signs can include chills, pain when you cough or inhale deeply, a headache, a sore throat, fatigue, and loss of appetite. “Shortness of breath is also a key sign,” said Dr. Von Essen. “If people have that problem, they need to be evaluated by a medical professional.”

Diagnosis

Generally speaking, walking pneumonia symptoms appear one to four weeks after you’ve been infected, and some symptoms, like coughing, can last a week to a month (or longer). However, infections due to Mycoplasma pneumoniae can go underdiagnosed because of how mild symptoms can be.

You'll usually get a physical exam and sometimes chest X-rays to diagnose walking pneumonia. Other tests such as blood tests and sputum cultures may be needed to confirm the bacteria causing the illness.

Walking Pneumonia Treatment

If it’s determined that you have walking pneumonia, you’ll typically be prescribed antibiotics. When antibiotics are started early, they can help you recover faster.

You can also make yourself more comfortable with plenty of rest and lots of fluids. Over-the-counter antihistamines (for nasal congestion), cough medications, and nonsteroidal anti-inflammatory drugs (for pain and discomfort) may ease some symptoms. Always check with a healthcare provider before giving any of these meds to a child.

When to See a Healthcare Provider

If symptoms get worse instead of better, head to a healthcare provider. In fact, it’s a good idea to head to your provider any time you have a lingering cough, especially if you’re older.

“If people are young and very healthy, it’s probably not as critical that they be seen right away,” said Dr. Von Essen. “But if they’re over 60 or 65, it can progress very fast. If you’re short of breath, if you feel dizzy when you stand, if you cough so much you can’t talk, it’s a good idea to be seen immediately.”

Although walking pneumonia usually isn’t life-threatening, it can be. It may also lead to meningitis (inflammation of the tissues lining the brain) or encephalitis (inflammation of the brain).

Prevention

Walking pneumonia spreads when an infected person coughs or sneezes. To reduce your risk of infection, follow these tips:

  • Get a flu vaccine
  • Get a COVID-19 vaccine
  • There is no vaccine for viral or mycoplasma pneumonia, but certain individuals should get vaccinated for pneumococcal pneumonia
  • Exercise, eat a well-balanced diet, and get adequate sleep
  • Wash your hands frequently and thoroughly with warm, soapy water
  • Don't smoke
  • Cover your mouth when you cough or sneeze

Also, avoid sharing cups, toothbrushes, and utensils so you don't spread your germs to others.

If you do have walking pneumonia, just because you could walk around doesn’t mean you should. “You’re not doing the world a favor being out and about,” said Dr. Von Essen. “It’s good to stay home if you’re coughing or if you have a fever. You’ll probably get well faster.”

A Quick Review

Walking pneumonia refers to a mild case of pneumonia. It's most often caused by bacteria and is spread from person to person by coughing, sneezing, and other ways of spreading respiratory germs.

The symptoms of walking pneumonia can be mild enough that you can continue your daily activities, hence the term "walking." It can feel like a bad cold with symptoms such as cough, fever, chest pain, mild chills, and headache. Like any infectious disease, it's important to rest and take care of yourself so you can recover back to health.

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