Got a cold or cough you can't shake?

When you have cold-like symptoms — headache, runny nose, cough and a sore throat — you likely slow down a bit, thinking you can beat it in a few days. But when the symptoms linger or worsen — not enough to knock you off your feet, but enough so that you can’t ignore them — you may have walking pneumonia.

Walking, or atypical, pneumonia strikes about 2 million in the United States each year. It tends to be less serious than traditional pneumonia, which causes 50,000 deaths and more than half a million emergency room visits annually. In fact, you can be up and walking around, unaware that you have this type of pneumonia — that’s how it got its name.
But walking pneumonia can still leave you feeling lousy. And it’s highly contagious. Here, pulmonologist Neal Chaisson, MD, explains how you can end up with this respiratory infection.
How walking pneumonia develops

Bacteria called mycoplasma pneumoniae cause walking pneumonia. Children and younger adults develop it most often — the infection spreads easily in crowded environments like schools and college dormitories.
But walking pneumonia can also hit nursing homes. The infection spreads when an infected person coughs or sneezes and other people inhale the bacteria.
Symptoms usually begin within two weeks of exposure, but the bacteria can incubate for up to a month — and you’re contagious during that incubation period. Over about four days, the symptoms gradually worsen and include:
Sore throat
Persistent, dry cough
Increased mucus
Chest pain when breathing
Violent cough
Antibiotics: Do you need them or not?

While some doctors may assess your symptoms, assume you have walking pneumonia and prescribe an antibiotic, Dr. Chaisson doesn’t recommend that approach. “The vast majority of patients with these symptoms have something viral, such as an upper respiratory infection, sinus infection or bronchitis,” he explains. Such illnesses are treated with time, rest and symptom-relieving medication.
Dr. Chaisson cautions that antibiotic overuse can lead to antibiotic resistance and an outbreak of Clostridium difficile. C. difficile, an intestinal infection that causes diarrhea and abdominal pain, is difficult to treat and can lead to death — particularly in elderly patients.
However, if symptoms linger for longer than a few days or if you have a chronic health issue, it is best to visit your doctor to see if you might have walking pneumonia. Chronic conditions include:
Kidney disease
Heart disease
Although walking pneumonia may go away on its own, antibiotics can make it pass more quickly. Walking pneumonia can be confirmed by a chest X-ray, which will show an area of infection in the lung.