Ongoing pneumonia is spreading. Doctors share the telltale symptoms to look out for, and different ways to treat it.

• Infections with walking pneumonia increased nationally as children returned to school this fall.

• The infection can be difficult to diagnose and testing is expensive.

• Doctors can choose different antibiotics to try first, working on a case-by-case basis.

A common infection known as “walking pneumonia” has been on the rise in the U.S. in recent months, especially among children and teens.

The respiratory disease caused by mycoplasma pneumoniae bacteria is often called walking pneumonia because it is usually milder than other lung infections. Patients may feel exhausted, cough and have a mild fever, but are often still well enough to continue their daily lives.

“It can be a little bit incognito, it can sneak up on people,” says Dr. Elizabeth Schlaudecker, medical director of infectious diseases at Cincinnati Children’s Hospital, told Business Insider.

The disease can be difficult to identify and expensive to test for, and can last for several weeks, making it a frustrating illness for families. Furthermore, the treatment is not necessarily one-size-fits-all.

Here’s what you need to know about how to recognize and treat it.

Watch out for persistent cough, fever and fatigue

The telltale signs of walking pneumonia are not clear. Diseases caused by mycoplasma pneumoniae are usually milder than infections caused by the more common bacterial pneumonia, Streptococcus pneumoniae.

Emergency room physician Russell Migita of Seattle Children’s Hospital says it’s difficult to know exactly how many of the patients he sees have cases of walking pneumonia, versus streptococcal pneumonia or viral pneumonia. Doctors often use a stethoscope to listen for a characteristic, localized ‘cracking’ sound in patients with walking pneumonia, but not every patient has this.

Testing for the bacteria that cause walking pneumonia is also expensive, relatively new, imperfect and may not be covered by insurance, Migita said, so it’s difficult for experts to know exactly how bad this fall outbreak really is, compared to recent years.

The latest CDC data on the tests that Are If this is done, it suggests that more toddlers will develop walking pneumonia this year than normally thought; The disease used to be seen as more common in school-age children. There have also been outbreaks among young adults living in dormitories, where the bacteria has plenty of time to incubate and spread.

Schlaudecker is part of the CDC surveillance network that tests patients across the country for mycoplasma bacteria. She said test results indicate infections peaked in late August and early September as children returned to school and began exchanging germs again. “Hopefully it’s starting to slowly subside, but we’re definitely still seeing it,” she said.

People who recently had the flu are also at increased risk of developing walking pneumonia.

Amoxicillin may not be your doctor’s first choice

New research suggest that there isn’t always a clear winner when it comes to the best treatment for walking pneumonia.

Although macrolide antibiotics, such as azithromycin, are the most common recommended treatment And should perform better than penicillin-based antibiotics such as amoxicillin on this bacterium, there is no good data on which medication actually best helps shorten and improve the course of this infectious disease.

In practice, Migita says doctors often use a mix of their own experiences, local disease trends, and a particular patient’s history and preferences to get an idea of ​​what might work. In some cases, patients get better without medication, but for bacterial pneumonia, an antibiotic can help. Doctors assess the situation on a case-by-case basis, similar to how they would treat an ear infection.

“Empirical treatment is what we do in most cases for most childhood infections because it is difficult to say what is causing it,” he said. “If you don’t get better within two to three days with your first antibiotic, get seen again.”

Doctors say that while walking pneumonia is not as serious as other seasonal illnesses that children pass on, such as the flu, COVID or RSV, it can still be a burden on families because it often lasts for a long time. In rare cases, walking pneumonia can lead to swelling of the brain, kidney problems, and difficulty breathing, and people with lung problems and a weakened immune system may be at greater risk for hospitalization with walking pneumonia.

Earlier this year, Schlaudecker’s 15-year-old daughter had a persistent cough that lasted a week after her mother thought it was just a cold. They went to her pediatrician, who listened to the girl’s chest with a stethoscope.

Without any examination, the daughter was diagnosed with walking pneumonia and a Z-Pak (azithromycin) was prescribed. Within 24 hours of starting her medication, the teen was feeling great again.

“She said, ‘Wow, this is so cool that we found out what it was and got the right medicine,” Schlaudecker said. “It was a good medical success story.”

Read the original article Business insider