12 Symptoms of Walking Pneumonia in Adults: How to Recognize This Silent Illness

Feeling slightly unwell but still managing to get done all the everyday tasks? You might be struggling with more than a cold and flu. Walking pneumonia can impact healthy adults with symptoms that are easily overlooked, delaying treatment.

In this article, we’ll break down the early symptoms of walking pneumonia in adults, why adults are more vulnerable, when to seek medical help, and how to treat and prevent it effectively. Let's read!

What is Walking Pneumonia?

Walking pneumonia, also called "atypical pneumonia," is a mild form of pneumonia. It is a lung infection that causes swelling of airways, filling of lungs' air sacs with mucus and other fluids, and a cough and high fever with mucus. You may be able to walk and perform daily activities without realizing you are affected by this infection — hence the name “walking.”

Did you know? Around 2 million cases of Mycoplasma pneumonia (a subtype of walking pneumonia) are reported yearly in the USA. Unlike typical pneumonia, it doesn’t usually require hospitalization. 

Walking pneumonia can affect anyone, but is more commonly seen in School-aged children, young adults, and adults in crowded environments like schools, dormitories, or offices

12 Symptoms of Walking Pneumonia in Adults

Identifying the symptoms of walking pneumonia becomes challenging because it shares symptoms similar to cold and seasonal allergies. But it is crucial to understand the specific signs for timely diagnosis and treatment. Here are the key signs of walking pneumonia in adults:

1. Persistent Dry Cough (Common)

• A first warning symptom that can last for more than one week.

• Often becomes worse at nighttime or after physical activity.

2. Fatigue and Weakness (Common)

• Feeling suddenly tired despite having rested.

• Might be mistaken for usual exhaustion.

3. Low-Grade Fever (Common)

• Body temperature may slightly increase (basically below 101°F or 38.5°C).

• Often comes along chills or slight sweating.

4. Chest Pain or Tightness (Common)

• A dull pain or a tightness-like feeling in the chest.

• Can worsen with deep breaths or coughing.

5. Headache (Common)

• Mild to moderate headache.

• Often occur because of dehydration or fever.

6. Sore Throat (Common)

• A common early symptom, due to damage to the respiratory tract lining.

• Sometimes confused with a cold or flu due to similar symptoms.

7. Shortness of Breath (Common)

• Described as difficulty breathing or feeling breathless.

• Noticeable, especially during engaging in physical activities.

8. Loss of Appetite (Common)

• Reduced energy levels and a feeling of unwellness can lead to a reduced appetite.

• Illness associated with walking pneumonia can also lead to a low desire to eat.

9. Ear pain (Less Common)

• Causes inflammation of the otitis media (middle ear)

• This can lead to fluid accumulation, eardrum swelling, and ear pain.

10. Skin rash (Less Common)

• Triggered by Mycoplasma pneumoniae, a bacterium that causes walking pneumonia.

• Rashes occur as a non-specific exanthem (looks like small, red, and short-lasting rashes on the limbs and trunks) and an erythema multiforme (appears target-like lesions with a central bulla).

11. Neck lump (Less Common)

• Inflammation leads to enlarged lymph nodes in the neck.

• Occurs as the body tries to fight off infections

12. Wheezing (in severe cases; Less Common) 

• Wheezing (whistling sound while breathing) because of blocked airways.

• Occurs due to fluid buildup and inflammation in the lungs.

The common symptoms listed above are frequently seen in adults with walking pneumonia, while the less common ones occur in fewer cases but may still signal walking pneumonia, especially if paired with the common symptoms.

If you're experiencing multiple symptoms, especially a lingering dry cough and fatigue, or even if you only have 1 or 2 symptoms that won’t go away, it’s worth getting checked by a doctor. Early diagnosis can prevent serious complications.

Why Are Adults More Prone to Walking Pneumonia?

Adults may be more vulnerable to walking pneumonia due to several reasons:

• Weakened Immune System: Age or chronic stress naturally lowers the ability of the body to fight off infections.

• Chronic Medical Conditions: Research reports that conditions such as diabetes, asthma, and heart disease can increase their risk of developing walking pneumonia.

• Reduced Lung Function: With age, the strength and capacity of the lungs reduce, making them more infection-prone.

• Delayed Symptom Recognition: Early signs often mimic a cold or fatigue.

When to See a Doctor?

Though some symptoms can be managed at home with antibiotics and rest, seek medical help if you experience:

• symptoms lasting for more than a week without improvement.

• Severe or sharp chest pain

• Breathing difficulty

• High fever

Prompt diagnosis and treatment can prevent complications, especially for those with underlying health issues.

Diagnosis of Walking Pneumonia

To confirm walking pneumonia, the doctors help with a physical examination, like listening to the lungs' sound and checking the symptoms. The providers may also order tests like:

• Chest X-ray: To examine the lungs and how much they have been affected.

• Sputum culture: To determine the pneumonia-causing bacteria by taking a mucus sample from the throat or nose.

• Blood test: A provider may take a sample of your blood to help determine which bacteria are the reason for your illness.

Walking Pneumonia Treatment Options

The treatment often depends on the cause:

1. Antibiotics:

If bacteria are causing walking pneumonia, the doctors provide the following antibiotics to kill the bacteria:

• Macrolide antibiotics: Include azithromycin and clarithromycin

• Fluoroquinolones: E.g., ciprofloxacin and levofloxacin

• Tetracyclines: Include doxycycline and tetracycline

Always complete the full course, even if you feel better early. Incomplete treatment can cause relapse or resistance.

2. Symptom Relief Medications:

These medications can help ease symptoms:

• Antihistamines: To manage nasal congestion

• Pain Relievers: Ibuprofen or acetaminophen to reduce fever, pain, and headache.

• Cough Suppressants or Expectorants: To ease coughing and help mucus clearance

Severe cases may require hospitalization for intravenous antibiotics (antibiotics delivered into a vein through injection or catheter) or oxygen therapy.

Moreover, supportive care is also crucial, which includes:

• Rest: Take a lot of rest to allow enough time for the body to fight off infections and recover.

• Hydration: Drink a lot of water and fluids to make mucus thin and maintain overall health.

• Balanced Diet: Consume a healthy diet rich in vitamins and other vital nutrients to strengthen the immune system.

Complications of Walking Pneumonia (If Left Untreated)

Although usually mild, walking pneumonia can escalate to serious complications:

• Acute respiratory distress syndrome (ARDS), a condition with low oxygen levels in the blood.

• Full-blown pneumonia

• Asthma attacks

• Encephalitis (inflammation of the brain)

• Hemolytic anemia, an illness in which the body kills red blood cells

• Meningitis, an inflammation of the meninges that surround the spinal cord and brain

• Respiratory failure

• Lung damage

• Kidney problems, such as renal dysfunction

• Skin conditions, like Stevens-Johnson syndrome or mycoplasma-induced rash and mucositis 

Causes of Walking Pneumonia

Knowing the causes can help manage and prevent this condition. Here are the potential causes:

• Bacteria: Examples include Mycoplasma pneumoniae & Chlamydia pneumoniae, often seen in crowded places like schools and nursing homes.

• Viruses: Examples are the respiratory syncytial virus & influenza virus. Both viruses can spread from the upper part of the respiratory tract to the lungs through respiratory droplets produced while sneezing or coughing.

Is Walking Pneumonia Contagious?

Yes, it is highly contagious because it:

• Spreads through airborne respiratory droplets

• Can be transmitted even before symptoms appear

• Contagious for 2 to 4 weeks

People with weakened immunity are especially vulnerable.

Preventing Walking Pneumonia 

The following preventive tips can help lower the risk of getting affected with walking pneumonia:

• Follow Good Hygiene: Wash your hands thoroughly and frequently, and do not touch your eyes, mouth, and nose.

• Wear Masks: Wearing masks in crowded areas or near someone who is sick can minimize the spread of bacteria.

• Avoid Close Contact with Sick People: Limit your exposure to people who are sick, especially those who have respiratory symptoms.

• Get Vaccinated: Get the flu vaccine, as the flu makes you more prone to develop walking pneumonia.

• Avoid Smoking: Do not smoke, and also don’t allow others too as smoking worsens the symptoms.

• Boost the Immune System: Consume a well-balanced diet, practice exercise regularly, get adequate sleep, and reduce stress.

These preventative measures, along with attention to early symptoms, can significantly lower the chances of developing walking pneumonia.

Final Thoughts

Though it might not seem severe at first, the lingering symptoms of walking pneumonia in adults can interrupt everyday life. Spotting the early signs — like persistent cough, fatigue, or chest discomfort — can help you get timely care and recover quickly, especially in older adults or those with pre-existing medical issues. If symptoms worsen or linger, don’t wait — see a doctor and take steps to protect your health and those around you.