Spot the difference between walking pneumonia or a cold

Pneumonia is an infection that causes fluid or pus to build up in the air sacs of the lungs.¹ The symptoms can be mild or very severe.

Walking pneumonia is a mild type of pneumonia. It"s called that because people with walking pneumonia have minor symptoms and can still walk around and do their daily activities.² One of the most common causes of walking pneumonia is Mycoplasma pneumonia (M. pneumonia). But, walking pneumonia can also occur due to:

• Molds
• Viruses
• Other types of bacteria

The symptoms of walking pneumonia usually include:

• A cough
• Fever
• Chills

Walking pneumonia often feels like a bad cold. Let"s look at what makes walking pneumonia different from a cold and your choices for treatment.

Find the best discounts on prescription drugs wherever you go.

Discover the free and easy way to save at over 64,000 pharmacies with Optum Perks.

Find coupons

Symptoms of walking pneumonia

Children under age five and adults who are 65 or older are most likely to get pneumonia.³ But people of any age can get sick from it.

Some people are at a greater risk of serious infection from pneumonia. A few common conditions that can cause an increased risk of pneumonia are:

• Diabetes
• Lung disease
• Heart disease
• Liver disease

People with a weakened immune system are also more likely to get pneumonia. Certain medications can also weaken your immune system.

Pneumonia can be caused by a bacteria, a virus or rarely a fungus, like mold. If the bacteria M. pneumonia is the cause of your walking pneumonia, you might not show any symptoms for 1 to 4 weeks.⁴ Common symptoms of walking pneumonia are:

• Cough
• Shortness of breath
• Fatigue
• Fever and chills
• Chest pain²
• Headache

Pneumonia caused by bacteria has more serious symptoms than other types of pneumonia. It can become more severe slowly or all of a sudden. You might experience:⁵

• Increased breathing or a faster pulse
• Excessive sweating
• A high fever, up to 105°F
• Blue lips or nails from a lack of oxygen in your blood

If your pneumonia is caused by a virus, your symptoms can last a few days. Your symptoms might be like the flu and include:

• Muscle pain
• Weakness
• A dry cough
• Headache
• Fever

But symptoms can get worse within 1 to 2 days. You might have a cough that worsens or trouble breathing.

Newborns and infants with pneumonia won"t always show signs of having it. If they do, they might have symptoms like:⁵

• Feeling tired
• Feeling restless
• A fever
• A cough
• Vomiting

Infants who are very sick might be unable to eat or drink. They may also experience unconsciousness or convulsions (uncontrollable muscle shaking). Some could have hypothermia, a condition where your body drops below 95° F.⁶

Children with pneumonia might also have stomach pain.⁷

Sometimes, walking pneumonia can get worse. According to Dr. Valentin, population health medical director at ProHealth Physicians, part of Optum, some common signs include:

• Increased shortness of breath
• Continuous high fever
• Intensifying chest pain
• Worsening cough
• General fatigue or confusion (particularly in older adults)
• Rapid heartbeat

If you get more severe pneumonia symptoms, it can cause dangerous complications. These include:⁸

• Respiratory failure: A condition that makes it difficult to breathe on your own because your lungs can"t get enough oxygen into your blood.⁹ It requires you to be put on a breathing machine.
• Acute respiratory distress syndrome (ARDS): This is a more serious type of respiratory failure.
• Lung abscesses: While this isn"t common, they occur when pus forms in or around the lung. They might have to be drained with surgery.
• Sepsis: This condition causes inflammation all over your body and can lead to organ failure.

You should seek medical care right away if you have more serious symptoms like chest pain or a high fever. Or if you or a child with these symptoms have trouble breathing.⁸

Walking pneumonia vs. a cold

You might wonder if you have walking pneumonia or the common cold. Walking pneumonia can feel very much like a bad cold. But the two are actually very different.

"Imagine your lungs are like a house," said Dr. Valentin, "A cold is like a cluttered living room — messy but functional. Walking pneumonia is more like a leaky roof — you might not notice it at first, but over time, the damage becomes more apparent and affects your comfort."

A cold is commonly caused by a virus.¹⁰ Rhinoviruses are the most common cause.¹¹

Symptoms usually become worse 2 to 3 days after you"re exposed to the germs. While the symptoms might feel bad, you can usually recover from a cold in 1 to 2 weeks. At the most, you might have symptoms for up to 3 weeks. A cold also doesn"t usually require medicine.

Symptoms of the common cold include:¹¹

• Runny nose
• Congestion
• Sneezing
• Cough
• Body aches

You might think you just have a cold and not treat it. But because walking pneumonia can be caused by bacteria, it"s important to treat it with antibiotics.

"One key difference is the severity and duration of the cough. With walking pneumonia, the cough is often more intense and lingers longer than with a cold. You might also feel more wiped out, and the fatigue doesn"t seem to match the mildness of other symptoms," said Dr. Valentin.

"Another clue is how you respond to over-the-counter treatments. Cold symptoms usually ease up with rest, fluids, and maybe some decongestants, if appropriate. If those aren"t cutting it, and you"re not bouncing back as expected that"s worth noting."

It"s also important to talk with your doctor if your symptoms last longer than a week or two, as this could be a sign of pneumonia. According to Dr. Valentin, if your cough is relentless or you feel extremely tired, it could be time to check in with your doctor.

Even if your symptoms are mild, it"s best to stay home and take care of yourself.

Chest cold vs. walking pneumonia

You could also have what"s commonly called a chest cold (acute bronchitis), which is when the airways in the lung swell and create mucus in the lungs.¹²

A chest cold often shares some symptoms with pneumonia. It can be caused by bacteria. Symptoms include:

• Headache
• Sore throat
• Body aches
• Feeling tired
• Soreness in the chest

Besides these, you might have different symptoms depending on the kind of cold you have. Children with a chest cold might also have even more symptoms.

Is walking pneumonia contagious, and how long does it last?

Walking pneumonia, like a cold, is highly contagious. It spreads from person to person through respiratory droplets. This means you can get pneumonia when someone who has it coughs, sneezes or talks near you. You then breathe in the droplets.¹³

If this happens, you might develop symptoms of walking pneumonia.

Some people might feel better after a week. Others might not feel better for a month or more. Most of the time, you might find that you feel tired for a month, no matter your symptoms.⁸ In general, with treatment, most people will recover in 2 to 4 weeks.¹³ It"s important to get a lot of rest while you"re recovering.

You should speak with your doctor if your symptoms don"t go away. This is really important if you have a condition like asthma¹⁴ or chronic obstructive pulmonary disease (COPD).¹⁵

How to test for walking pneumonia

If you think you have walking pneumonia, it"s best to see your doctor. They"ll probably ask about your symptoms. They might also ask you about any factors that might put you at risk, like:¹⁶

• Previous and current health issues, especially if they"ve recently become worse
• Smoking
• Recent travel
• Exposure to birds or other animals
• Prescribed medication
• Flu or pneumonia vaccines
• Exposure to people who are sick at home, school, or a hospital (if you work in one)

They might also do a physical exam to look for signs of walking pneumonia. If your doctor thinks you have pneumonia, they"ll probably do one or more of these tests:

• A chest X-ray.
• A blood test.
• Pulse oximetry, which is a test that figures out how much oxygen is in your blood. This is important because pneumonia can prevent your lungs from getting oxygen into your blood.

Treatment for walking pneumonia

If your walking pneumonia is caused by M. pneumonia, you can usually recover without taking medication.¹⁷ Your doctor might prescribe over-the-counter medications like cough syrup or cold medicines.

In general, if your pneumonia is caused by bacteria, your doctor might prescribe antibiotics for 1 to 3 days.¹⁸ Make sure to take them as prescribed. If you stop taking the antibiotics too early, your pneumonia might come back.

"In addition to taking the antibiotics prescribed by your healthcare provider, you should stay hydrated," said Dr. Valentine. "Water helps thin the mucus and keeps your immune system functioning optimally. Rest and giving your body time to heal are very important. Do not underestimate the power of good sleep. Herbal teas and honey can soothe a sore throat and reduce the coughing."

Before giving you an antibiotic, your doctor will make sure the cause isn"t M. pneumoniae. This type of bacteria is resistant to some antibiotics that help with pneumonia caused by different bacteria.¹⁹

Keep in mind that antibiotics don"t help with viruses. Therefore, they won"t help fight pneumonia that"s caused by a virus. Your doctor might prescribe an antiviral medication. But these don"t always help with every virus that causes pneumonia.²⁰

If the cause of your symptoms is M. pneumonia, the type of antibiotics your doctor will suggest depends on your age. The medication could be antibiotics like:²⁰

• Macrolides for children and adults
• Tetracyclines for older children and adults
• Fluoroquinolones for adults

If a person isn"t getting better on one kind of antibiotic, a doctor can try a different one, even for young children.

You can help stop the spread of walking pneumonia through the following measures:²¹

• Cover your mouth when you cough and sneeze.
• Wash your hands regularly.
• Make sure to clean and disinfect surfaces often.
• You should stay away from smoking or quit smoking if you can.
• Be sure to take care of any long-term illnesses like asthma.
• As much as you can, try to stay away from other people.
• Be sure to get vaccines that can protect you against bacterial infections and viral infections.

Summary

Walking pneumonia is a lung infection caused by bacteria, viruses and, rarely, fungi. It can cause symptoms like shortness of breath. Most cases of walking pneumonia are mild.

A doctor can test you for pneumonia and figure out the cause. If you need treatment, they can prescribe antibiotics or other medicines.

Be sure to talk with your doctor if you"re concerned about your symptoms. Good health starts with primary care to stop problems before they start. Optum"s doctors and care teams offer you the care you need, when you need it.