Understanding Walking Pneumonia in Kids

Walking pneumonia is primarily caused by the bacterium Mycoplasma and is a milder form of pneumonia, an inflammation of the lungs, seen in children and adolescents. Walking pneumonia is common. In children, Mycoplasma typically affectsschool-aged children and adolescents, though it is starting to be found more in younger children, as well.  

What is walking pneumonia? 

There are no exact criteria to define walking pneumonia. Generally, it is characterized by a gradual onset of symptoms that can sometimes be mistaken for a common cold. Symptoms may include: 

• Persistent cough
• Mild fever
• Fatigue
• Headache
• Chest discomfort
• Sore throat
• Mild rash 

“Children under five years of age may also experience symptoms such as: diarrhea, sneezing, stuffier nose, vomiting and watery eyes,” said Todd Florin, MD, Emergency Medicine. “Despite these symptoms, children with walking pneumonia typically remain active and can often go about their daily activities, hence the term ‘walking.’”  

What is regular pneumonia?  

In contrast, regular pneumonia, which can be caused by various bacteria, viruses, or fungi, tends to have a wide range of symptoms ranging from mild to severe. Symptoms of regular pneumonia include: 

• Fever
• Severe cough with or without phlegm production
• Shortness of breath
• Chest pain
• Rapid breathing 

Children with regular pneumonia may exhibit signs of significant illness, often requiring medical attention and possibly hospitalization. 

Key Differences Between Walking Pneumonia and Pneumonia   

Although there may be some overlap, there are key differences between walking pneumonia and pneumonia: 

• The severity of symptoms: Walking pneumonia often has milder symptoms, allowing children to maintain normal activities, whereas regular pneumonia has a wider range of symptoms, ranging from mild to severe.
• Timing of symptoms: Walking pneumonia generally presents more gradually, with low-lying symptoms that can persist for several days to a week or two. Regular pneumonia can occur with more sudden onset of symptoms within a day or two.

Causes and Diagnosis 

Walking pneumonia is primarily due to Mycoplasma pneumoniae, while regular pneumonia can result from various pathogens, including Streptococcus pneumoniae and viruses. Regular pneumonia is most often caused by viruses in children. “Walking pneumonia is very contagious and spreads through droplets when someone who is infected coughs, sneezes, breathes or talks near you and you inhale those droplets. You are considered contagious for two to four weeks during incubation until symptoms end,” said Dr. Florin. 

Walking pneumonia is often diagnosed based on clinical symptoms and may not require extensive testing. In children with mild symptoms, it is not necessary to perform any testing. In contrast, regular pneumonia sometimes necessitates chest X-rays to confirm the diagnosis. If your child or teen is experiencing symptoms, symptoms that worsen, it’s important to seek medical care. Very rarely, Mycoplasma can cause more severe disease that includes severe blistering rash/skin findings or neurological complications. Patients with these findings require prompt medical attention. 

Walking Pneumonia Treatment

Most walking pneumonia that is mild enough to be managed at home resolves without any specific treatment other than ensuring that the child or teen is well hydrated, that fever is controlled to make the child comfortable, and if cough is bothersome, treatment-focused on symptomatic relief. More significant cases of walking pneumonia are typically treated with antibiotics that target Mycoplasma, and recovery can take a few weeks.

Regular pneumonia can be treated in several ways: mild pneumonia thought to be due to viruses can be treated with supportive care like walking pneumonia and without antibiotics, pneumonia thought to be due to bacteria may require antibiotics, and those ill enough to require hospitalization may require stronger antibiotics and more intensive medical care, especially if complications arise. 

Preventing Walking Pneumonia 

Preventing walking pneumonia, like many respiratory illnesses, involves several proactive measures: 

• Good hand hygiene: Encourage frequent handwashing with soap and water, especially after coughing or sneezing. Using hand sanitizer can also help reduce the spread of germs. Because walking pneumonia is spread through droplets, teach children and teens to “sneeze and cough in their sleeve.”
• Avoid contact: Keep children away from those who are sick. Respiratory infections can spread easily in crowded places, such as schools and daycare centers. If your child or teen is sick have them stay home to prevent the spread of illness to others.
• Vaccinations: Ensure that children receive recommended vaccinations, including the pneumococcal vaccine and flu shots, which can help prevent infections that may lead to pneumonia. There is no vaccine currently available for Mycoplasma.
• Healthy lifestyle: Promote a balanced diet, regular exercise, and adequate sleep to strengthen the immune system.Maintain good indoor air quality by avoiding smoking around children, using air purifiers, and ensuring proper ventilation in living spaces.

Awareness of symptoms, combined with preventive measures, can help ensure that children healthy and receive the appropriate care if they become ill. If a child exhibits signs of either condition, contact your primary care provider or pediatrician.  

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