What is walking pneumonia? It can progress quickly — know the signs and when to seek help

Walking pneumonia has been on the increase, especially among children, according to the U.S. Centers for Disease Control and Prevention. It’s important to be aware of the signs and symptoms to prevent any cases from developing into something more severe.

Pneumonia is an infection of the airspace in the lungs. While walking pneumonia tends to be a milder form of the illness, it can sometimes progress quickly.

Left untreated, pneumonia can rapidly become life-threatening. Given the importance of the lungs, if you suspect any type of pneumonia, it’s important to seek medical care as soon as possible.

Pneumonia vs. walking pneumonia vs. bronchitis

Pneumonia

Standard pneumonia infects the deeper lungs, lung space and lung air sacs.

Symptoms include:

• cough
• severe fatigue
• fever
• sputum/phlegm production
• shortness of breath

If it becomes severe, standard pneumonia can lead to respiratory failure.

Pneumonia can be caused by viral or bacterial infections. Sometimes, a viral pneumonia can leave the body inflamed, without its natural ability to clear infection. This can make it more susceptible to a bacterial infection. So, we might see someone with both viral and bacterial pneumonia infections at the same time.

Walking pneumonia

Walking pneumonia, also referred to as atypical pneumonia, is usually a milder case but will still cause a cough, tiredness and some chest discomfort. You usually can “walk around” with it because it doesn't require significant bed rest, and you don’t feel the severity of the illness as significantly as you would with standard pneumonia.

However, left untreated, walking pneumonia can develop into standard pneumonia, especially if you have an underlying condition, such as asthma or chronic obstructive pulmonary disease (COPD).

Walking pneumonia is often caused by mycoplasma bacteria.

Bronchitis

Bronchitis is an inflammation of the passages that carry air to and from the lungs. It tends to stay confined to the upper airway and usually doesn’t affect the deeper lungs and air sacs. But bronchitis can become severe for some people.

It can have symptoms similar to pneumonia, but it is typically characterized by a nagging cough that can last up to a few weeks.

It’s caused by a virus and will generally resolve on its own over time. If you have bronchitis, you can use lozenges or hot tea (with or without honey) to help manage cough. Smoking cessation is strongly recommended for those who smoke. Over-the-counter medications like dextromethorphan (cough suppressant) or guaifenesin (an expectorant, or something that loosens mucus) can also help control cough.

How pneumonia is treated

Viral pneumonias, like most other illnesses caused by viruses, are treated by handling the symptoms as mentioned above for bronchitis. Acetaminophen (Tylenol) may be used for fever or muscle/joint aches.

A bacterial pneumonia can be treated with an antibiotic.

When symptoms become severe for any type of pneumonia, then steroids, inhalers, oxygen treatments and mechanical ventilation might be needed.

When to see a health care provider

See a health care provider right away if you:

• have significant chest pain
• have a fever that isn’t improving
• experience shortness of breath
• feel unusually winded

Preventing pneumonia

Pneumonia spreads through viruses and bacteria in airborne respiratory droplets.

These viruses and bacteria are often called “winter bugs” because they tend to show up more often in the colder months, when many of us are confined indoors in smaller spaces.

To help prevent pneumonia and support the immune system:

• get vaccinated, if eligible
• practice good hand hygiene
• avoid people who sound sick
• get adequate sleep
• eat a balanced diet
• exercise regularly to build lung capacity

Pneumonia vaccination

There are hundreds of viruses that can cause pneumonia. For example, the influenza, respiratory syncytial virus (RSV), COVID-19, adenovirus and parainfluenza viruses can all cause standard pneumonia. There are also many bacteria and even some fungal infections that can cause pneumonia.

The pneumonia we typically vaccinate against is streptococcus pneumonia, caused by bacteria.

Current available vaccines are PCV15, PCV20, PCV21 and PPSV23. The numbers reflect the amount of streptococcus pneumonia strains against which the vaccine offers protection.

Vaccination is recommended for those at increased risk:

• children younger than 5 years
• adults 50 and older, especially those 65 and older
• adults with lung conditions, such as asthma and COPD
• adults with chronic health conditions, such as diabetes or heart failure
• adults with autoimmune conditions
• adults with compromised immunity from cancer treatment, medication or a medical condition

We sometimes offer multiple vaccines because the strains each vaccine treats for are not necessarily the same.

Pneumonia in children

Children with pneumonia may have cold-like symptoms and a cough, but they may also have atypical symptoms. Babies may be lethargic or take in less food or milk, or you might notice that retractions of the chest wall are a bit more labored during breathing. If you notice these signs or other unusual signs of distress, especially in an infant 6 months old or younger, contact a health care provider as soon as possible.

Older children may have faster heart rates, wheezing may start a little earlier, and you may notice a decreased appetite, along with standard symptoms experienced by adults.