Walking pneumonia is also known as atypical pneumonia, chamydophila pneumonia, community acquired pneumonia. It refers to pneumonia which is caused by certain bacteria like Legionella pneumophila, Mycoplasma pneumonia and Chlamydophila pneumonia.
Causes: Pneumonia due to Legionella is seen in middle aged and older adults, smokers, those with a weakened immune system, immunocompromised hosts like those suffering from HIV, patients who have undergone chemotherapy, those taking immunosuppressive medications and those suffering from long standing debilitating diseases. Legionella is the causative Mycoplasma pneumonia is also another type of walking pneumonia. It is caused by bacteria called M. pneumonia. It usually affects people under the age of 40. Chlamydia is another organism that accounts for 15 % of all pneumonias.
Symptoms: The most common symptoms of pneumonia are fever with chills, weakness, cough which may be productive, haemoptysis is seen in a few cases and dyspnoea from exertion. Other symptoms are loss of appetite, fatigue, lethargy, confusion, chest pain on deep inspiration, headache, muscle pains and body ache. Patients suffering from mycoplasma pneumonia usually run a milder course and present with added symptoms like sore throat, difficulty in swallowing, enlarged lymph nodes in the neck, ear pain and a rash on the body. Patients suffering from Legionella pneumonia run a severe course of the illness and may develop diarrhea in addition to the other symptoms.
Signs and Diagnostic tests: On examination, the patient will be febrile. To confirm pneumonia the physician may ask for tests such as a chest radiograph, complete blood count, sputum smear and culture, blood cultures, CT scan of the chest may be needed in some cases.
Treatment: It is important to control the temperature; the physician may prescribe drugs like paracetamol, ibuprofen, acetaminophen etc. Antibiotics are required to treat cases of walking pneumonia. Antibiotics may be given orally or intravenous, for intravenous administration the patient may be advised to be hospitalized, this in turn depends on the condition of the patient and the severity of the illness. Rest is important to aid speedy recovery. The patient is also advised to drink plenty of oral fluids. The most commonly used antibiotics to treat a case of atypical pneumonia are azithromycin, clarithromycin, fluoroquinolones like levofloxacin and tetracyclines like doxycycline. The prognosis of patients suffering from mycoplasma or chamydia infection improves very well on antibiotic therapy. Those suffering from Legionella infection run a risk of worsening and systemic spread of the infection, hence the prognosis is variable.
Complications: Complications of walking pneumonia is spread of the infection. Some cases may present with complications like meningitis, myelitis, encephalitis and these conditions need prompt diagnosis and treatment in order to prevent fatalities.
Prevention: It is important to follow hygienic conditions like washing of hands regularly especially after visiting lavatories. In patients having a weak immune system, they must use a mask when in crowded places as there is a high chance of them suffering from an air borne infection. Patients with a weak immune system may be given vaccination against pneumonia. But one must remember that vaccination does not give complete protection from all species of bacteria causing pneumonia.
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