Mycoplasma pneumoniae is a common respiratory pathogen that can cause respiratory tract infections, tracheobronchitis and pneumonia. Because the symptoms of pneumonia caused by Mycoplasma pneumoniae are often relatively mild, affected individuals may still be able to carry on with their daily activities. For this reason, it is often referred to as "walking pneumonia". Mycoplasma pneumoniae infection is particularly common among children and adolescents, although adults can also become infected.

Understanding Mycoplasma pneumoniae symptoms, how it spreads, its incubation period and available treatments can help parents and adult patients recognise the condition early and seek medical advice when needed.

Mycoplasma pneumoniae infection usually develops gradually, with symptoms appearing over time. Common symptoms include: 

• Fever 
• Cough 
• Sore throat 
• Headache 
• Fatigue 

Younger children may present differently from older children and adults.

Children under five may develop:  

• Runny nose 
• Sneezing 
• Wheezing/ coughing 
• Sore throat 
• Vomiting 
• Diarrhoea 

School-age children with Mycoplasma pneumoniae infection more commonly experience:

• Fever (typically low-grade)

• Headache

• Persistent cough 

• Sore throat
• Malaise

• Pneumonia 

If your child has a persistent high fever, a noticeably worsening cough, shortness of breath or declining alertness, seek medical attention promptly.

Onset is typically gradual and insidious, developing over several days to weeks. Many adult infections are mild or even asymptomatic.

Adults commonly experience:

• Persistent dry cough 

• Low-grade fever 

• Sore throat

• Headache 

• Fatigue 

• General malaise 

• Chills

In more severe cases or when pneumonia develops: 

• Dyspnoea 
• Productive cough with non-bloody sputum 

 A combination of clinical assessment and targeted investigations can help identify M. pneumoniae infection. 

Laboratory testing

• PCR: nose/throat swab, with fast and accurate results.

• Blood test (serology): Looks for the body's immune response to the infection  

Most mild Mycoplasma pneumoniae infections resolve on their own. However, if the infection has progressed to pneumonia or symptoms are more severe, your doctor may prescribe antibiotics.

Because Mycoplasma pneumoniae lacks a cell wall, beta-lactam antibiotics such as penicillins are typically ineffective. Depending on the patient's age, clinical presentation and risk of antibiotic resistance, your doctor may consider macrolides, tetracyclines or fluoroquinolones.

When antibiotic treatment is needed for children, doctors usually consider macrolide such as azithromycin. The choice of treatment will depend on the child's age, severity of illness and local resistance patterns.

If a patient with suspected or confirmed Mycoplasma pneumoniae infection does not improve on macrolides, the doctor may consider a second-line option such as doxycycline, though the potential side effects in children and pregnant women require careful consideration. 

There is currently no vaccine to prevent Mycoplasma pneumoniae infection. Prevention therefore focuses on maintaining good personal and environmental hygiene to reduce the spread of respiratory droplets. 

• Wash your hands frequently with soap and water, especially before touching your mouth, nose or eyes, and after coughing or sneezing. 

• Cover your mouth and nose with a tissue when coughing or sneezing and dispose of the tissue properly. 

• If you develop a fever or respiratory symptoms, wear a surgical mask, stay home from work or school, and see a doctor as soon as possible. 

• Keep indoor areas well-ventilated and regularly clean frequently touched surfaces. 

• Avoid close contact with children, older adults and immunocompromised individuals until your symptoms have improved. 

• Sanitise frequently touched surfaces such as doorknobs and mobile phones every 4 hours using approved, appropriate disinfecting solutions. 

1. Centers for Disease Control and Prevention. (2026). 'Clinical overview of Mycoplasma pneumoniae infection.' Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/mycoplasma/hcp/clinical-overview/index.html [Accessed: 8 July 2026].

2. Saraya, T. (2017). 'Mycoplasma pneumoniae infection: basics.' Journal of General and Family Medicine, 18(3), pp. 118 to 125. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5689399/.

3. Centre for Health Protection. (2025). 'Mycoplasma pneumoniae infection.' Centre for Health Protection. Available at: https://www.chp.gov.hk/en/healthtopics/content/24/21283.html [Accessed: 8 July 2026].

4. Centers for Disease Control and Prevention. (2026). 'About Mycoplasma pneumoniae infection.' Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/mycoplasma/about/index.html [Accessed: 8 July 2026].

5. Abdulhadi, B. and Kiel, J. (2023). 'Mycoplasma pneumonia.' StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430780/ [Accessed: 8 July 2026].

6. Centers for Disease Control and Prevention. (2024). 'Information for laboratories: Mycoplasma pneumoniae.' Available at: https://www.cdc.gov/mycoplasma/php/laboratories/index.html [Accessed: 8 September 2026]. 
7. Pahal, P., Rajasurya, V. and Sharma, S. (2023). 'Mycoplasma infections.' StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK536927/ [Accessed: 8 September 2026].