‘Tis the season of the respiratory infection. This season has been especially confusing with the
increasing rate of walking pneumonia. As a pediatrician, I often encounter parents concerned
about their child’s cough, runny nose, or sore throat, especially during cold and flu season.
Respiratory infections are common in children, but it’s helpful to understand the different types
to better navigate symptoms and treatment options.

Viral Infections

The most common respiratory infections in children are viral. Viruses like the common cold, flu,
and RSV (respiratory syncytial virus) spread easily, especially in school settings. Viral infections
tend to cause symptoms such as a runny nose, congestion, cough, sore throat, and sometimes
a fever. These symptoms often come on gradually. Since antibiotics don’t work against viruses,
treatment usually focuses on supportive care: rest, hydration, and sometimes over-the-counter
medicines to manage discomfort.

Bacterial Infections

Bacterial infections, such as strep throat or bacterial pneumonia, are less common but often
more intense. Symptoms may include high fever, a sore throat with white spots (for strep), ear
pain (for ear infections), and a productive cough (for bacterial pneumonia). These infections
may come on suddenly and feel more intense than viral ones. In cases where we suspect a
bacterial cause, antibiotics can be effective, helping reduce symptoms and preventing
complications.

Walking Pneumonia

Walking pneumonia, caused by Mycoplasma pneumoniae bacteria, is a mild form of
pneumonia. It doesn’t typically cause the intense symptoms of bacterial pneumonia, so children
are often still up and moving around—hence the name “walking” pneumonia. Symptoms can
include a lingering cough, fatigue, and low-grade fever. It may feel like a cold that just won’t go
away. Walking pneumonia may not always require antibiotics, but if symptoms persist or are
bothersome, your pediatrician might prescribe one to help your child recover faster.

When to Seek Medical Advice

If your child has a fever lasting more than three days, breathing difficulties, or persistent
symptoms, it’s always best to consult your pediatrician. We’re here to help guide you on whether
further treatment or testing might be needed.

Remember, each infection type has its own treatment approach, and not all respiratory illnesses
need antibiotics. By recognizing the differences, we can work together to get your child back to
feeling their best!