Walking pneumonia in kids: Symptoms and treatment

When your child coughs or ends up with a sore throat, you may not rush them to a nearby hospital. In fact, they may be going to the school and playing outdoors with their friends. However, coughs, and sore throat may be signs of walking pneumonia, which is an informal term used for a common bacterial health condition. It is a mild form of pneumonia, a serious respiratory infection that affects the lungs. Even though walking pneumonia in kids does not necessarily call for a hospital visit, it is important to get treatment on time.

What is walking pneumonia?

Also known as atypical pneumonia, walking pneumonia is a type of lung infection. “It is a mild form of pneumonia that often affects children,” says pediatrician Dr Preetha Joshi. Every year, around 120 million episodes of pneumonia occur in kids younger than 5 years of age. This leads to at least one million deaths across the globe, as per research published in the Pneumonia journal in 2015.

In case of walking pneumonia in kids, most children do not feel sick enough to stay at home or stop their activities. That’s why it’s called “walking” pneumonia. But once diagnosed, make sure they stay home, receive the right antibiotics and recover well.

What causes walking pneumonia in kids?

Walking pneumonia in kids is most commonly caused by mycoplasma pneumoniae, according to the American Lung Association. “It is a type of bacteria that spreads through respiratory droplets when a person infected with it coughs or sneezes,” says the expert. Unlike typical bacteria, mycoplasma pneumoniae lacks a rigid cell wall, sometimes making it resistant to antibiotics. It can infect anyone, but it most often targets children aged between 5 and 17 years and young adults, according to the US Centers for Disease Control and Prevention.

“Other bacteria like chlamydia pneumoniae, and certain viruses such as influenza, and respiratory syncytial virus can trigger walking pneumonia in kids,” says Dr Joshi.

What are the symptoms of walking pneumonia in kids?

Children may have symptoms like diarrhea, wheezing or vomiting, as per the CDC. Other signs of walking pneumonia in kids are:

• Cough that can last for weeks
• Sore throat
• Headache
• Fatigue, especially while engaging in sports or physical activity.
• Low-grade fever
• Chest pulling in during breathing, which is a sign that your child is working hard to breathe.
• Sometimes fever may be accompanied by chills.

What are the stages of walking pneumonia in kids?

Walking pneumonia in kids goes through the following stages:

• Incubation period, which lasts 1-4 weeks, during which the bacteria multiply in the respiratory tract without showing any symptoms.
• After the incubation period, symptoms gradually appear.
• A persistent dry cough develops, often worsening at night. Chest discomfort and mild to severe shortness of breath may also occur.
• While walking pneumonia is mild, it can sometimes progress to full-blown pneumonia if left untreated. “In such cases, you will notice more pronounced respiratory symptoms like increased cough, chest pain, and difficulty breathing,” says the expert. In this phase, your child may need to be admitted to the hospital.
• In the recovery stage, symptoms usually improve within a few weeks with appropriate treatment, but the cough may linger for weeks or even months.

How is walking pneumonia in kids diagnosed?

Walking pneumonia in kids is diagnosed by a detailed medical history and careful examination.

• The examination of the respiratory system may suggest pneumonia and the doctor would ask for an X-ray of the chest.
• The mucus samples would be collected from the nose or throat for a definitive diagnosis.
• There are also blood tests that can check the immune reaction by the body against Mycoplasma.

How to treat walking pneumonia in kids?

Walking pneumonia treatment involves the following:

1. Symptomatic treatment

“For fever, medicines like paracetamol, and ibuprofen may be given. The doctor may give cough syrups and suggest steam inhalation too,” says the expert. Some children have hyperreactive airway disease, which is a condition where the airways are hypersensitive to irritants. “In such cases, your child will need bronchodilator, a type of medication that makes it easier to breathe,” says Dr Joshi.

2. Definitive treatment

After diagnosing mycoplasma pneumonia, antibiotics are the only effective and definitive treatment. “A 5- to 10-day course of oral antibiotics is usually recommended to treat walking pneumonia in kids,” says the expert. Sometimes, it can go beyond 10 days.

3. Treatment in severe cases

Some children may need respiratory support in the form of oxygen, non-invasive or invasive ventilatory support. “The infection can be resistant to the first line of antibiotics and may need stronger antibiotics for a longer duration. If it turns into severe pneumonia, a course of steroids may be given,” says the expert.

4. Personal hygiene measures

After starting on antibiotics, your child is less likely to pass the illness to you or other family members. “Still, make sure they wash their hands properly, and cough or sneeze into their elbow,” says the expert. Also, make sure that your kids are up to date when it comes to their immunisation to help protect them from other infections.

“Your child can take anywhere from 2 weeks to 6 weeks for complete recovery. Don’t stop them from taking antibiotics till the course is completed,” says the expert.

Walking pneumonia in kids is quite common. Even though it is mild, it should be treated so that it does not turn into severe pneumonia. Make sure to give medications to your child only after consulting a doctor.