What is Walking Pneumonia?

Question

Dear Dr. Greene, Thanks for this wonderful service!!! My daughter's friend has been diagnosed with "walking pneumonia." What is it? How serious is it? Is my daughter likely to get it?
Redwood City, California

Dr. Greene's Answer

The word pneumonia sounds alarm bells in many parents. It is understandably disturbing, because some pneumonias are quite serious, particularly in those whose immune system is vulnerable (newborns, the elderly, and people with AIDS). The good news is that the great majority of pneumonias in children and adolescents are easily treatable.

Pneumonia simply means inflammation in the lung. It can be caused by microorganisms, viruses, chemical irritants, or foreign bodies. The phrase “walking pneumonia” refers to a group of pneumonias that, even if untreated, would not usually need bed rest or hospitalization. They can, however, make someone feel miserable with a severe cough, fever, chills, headache, and abdominal pain and they can last a long time.

What is it?

When physicians diagnose someone with walking pneumonia, they are usually referring to an infection with an organism called Mycoplasma pneumoniae. (Apart from being a pain, mycoplasmas are kind of cool. They are the smallest self-replicating biologic systems known.) Mycoplasma is a major cause of respiratory infections in school-aged children and young adults. It is most common between the ages of 5 and 15, accounting for 70% of pneumonias in children aged 9 to 15.

Is Walking Pneumonia Contagious 

Mycoplasma can be contagious with close contact. It usually requires prolonged contact to catch the disease. Epidemics have been reported in situations such as summer camps and boarding schools. The disease spreads through breathing air coughed by someone who is infected. Since the cough is often worse at night, people sleeping in the same room are most vulnerable. If your daughter has been spending a lot of time with her friend, chances are high that she will get it.

She will probably begin to get ill 1 to 3 weeks after her friend, but the onset is often so gradual that she may not notice it at first. A decrease in her energy level may be the earliest sign, followed by cold symptoms . She may have a headache, runny nose, and sore throat, sometimes accompanied by a fever. Unlike a cold, however, she will gradually get worse over about 2 weeks, with an increasing moist cough (and perhaps hoarseness) as the disease settles into her chest. Without treatment she will likely remain sick for a month or more.

Are There After Effects?

Even after she is well, she may have a dry cough lasting for 6 more weeks. Mycoplasma attacks the ciliated cells of the respiratory tract – those with little hairs on the surface. As new cells grow in to replace the damaged ones, there is a ‘tickle’ in the chest, causing a sporadic deep, dry cough.

How is Walking Pneunomia Treated?

Thankfully, mycoplasma infections are easy to treat – with the right medicine. The most common antibiotics in children are no help at all! Mycoplasma is exceptionally sensitive, however, to erythromycin, clarithromycin (Biaxin), azithromycin (Zithromax or Z-pak), and tetracyclines (usually only used over age 8). Your daughter will usually start to feel better within about a week of taking any of these medicines.

Should she take other medicines to help relieve her symptoms? Perhaps. Many of the symptoms in walking pneumonia are part of her body’s attempt to heal. The invading organisms don’t reproduce as well when she has a fever. The runny nose is an attempt to expel the invaders. The tiredness is a plea from her body to get some rest.

The cough keeps the infection from settling too deeply in her lungs. I would not recommend cough medicine except when the cough is disturbing her sleep – it is when she sleeps that her body is most actively repairing itself. Do keep in mind is that over-the-counter cough and cold medications are no longer available for children under 2 years old, and their use is discouraged in children under 6 years old.

Last medical review on: January 13, 2015
About the Author
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Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.
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Hi Sabrina,

I’m so sorry to hear this. Has your cough continued? Have you been checked?

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I was told I have walking pnemonia and was put on zpac, I only have 2 days worth of medicine left and on third day I developed a dry cough. It’s more persistent now then what it was when I got checked. Is that normal??

Hi Sabrina,

I’m so sorry to hear this. Has your cough continued? Have you been checked?

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I’m 59 years old and female. I was diagnosed a couple of years ago with COPD and I was beyond scared! My lung function test indicated 49% capacity. After having had flu a year ago, the shortness of breath, coughing and chest pains continued even after being treated with antibiotics. I’ve been smoking two packs a day for 36 years. Being born without a sternum caused my ribs to be curled in just one inch away from my spine, resulting to underdeveloped lungs. At age 34 I had surgery and it was fixed. Unfortunately my smoking just caused more damage to my already under developed lungs. The problem was having is that I enjoy smoking and don’t want to give up! Have tried twice before and nearly went crazy and don’t want to go through that again. I saw the fear in my husband and children’s eyes when I told them about my condition then they start to find solution on their own to help my condition.I am an 59 now who was diagnose COPD emphysema which I know was from my years of smoking. I started smoking in school when smoking was socially acceptable. I remember when smoking was permitted in hospitals. It was not known then how dangerous cigarettes were for us, and it seemed everybody smoked [redacted] I wish anybody who starts smoking at a young age would realize what will eventually happen to their bodies if they continue that vile habit throughout their life.

Hi Dr. Greene! I sure wish I would have read this before spending money to go to the urgent care (as a cash payor) when I was so sick from coming back from my overseas trip as this is EXACTLY what I have. After two weeks of being sick with these symptoms they misdiagnosed me with Bronchitis… gave me an inhaler and other things that did absolutely nothing … so for 3 more weeks I got sicker. Then went to my primary care when I couldn’t sleep at night the cough was so bad and lungs hurt and paid more cash and yes…seems to be walking pneumonia and right away seemed to know after examination. My question is…I have just finished my Z pack and feel a lot better but I have ears plugged and feeling very very fatigued… should I rest more or go back to doctor or is it normal to still have a dry cough and feel this way. I went outside in the cold the other night and not sure if that was wise but feel really exhausted and off and while cough NOT nearly as bad and can breathe out without problems still having issues and congestion. Thank you!

Hi Carrie,

Have you tested your house for mold? Mold grows best in warm, moist places with little ventilation. Do you use a dehumidifier? We have a dehumidifier running in our home because we live in a humid climate. We get up to two gallons of water out of the air in 24 hours. Crazy, right? But it keeps our home mold free and that’s important.

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

I agree that mold can definitely be an issue and i know it makes me not well for sure.

Hi Carrie,

Have you tested your house for mold? Mold grows best in warm, moist places with little ventilation. Do you use a dehumidifier? We have a dehumidifier running in our home because we live in a humid climate. We get up to two gallons of water out of the air in 24 hours. Crazy, right? But it keeps our home mold free and that’s important.

Best, @MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.

My Mom started telling my doctors that I am allergic to amox and penicillin because they NEVER work.

Omglmao !!

I hope he laughed too

I think you need to seriously consider a psychology doctor for your condition. I think you have convinced your mind and body that you have this therefore you do.

Tracy,

Depending on where you live, there are services to help you get transportation to medical treatment. If you are comfortable sharing your location, perhaps some of our readers can find links to the services you need.

@MsGreene
Note: I am the co-founder of DrGreene.com, but I am not Dr. Greene and I am not a doctor. Please keep that in mind when reading my comments and replies.