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Hospital Acquired Pneumonia

Medically reviewed by Last updated on Jan 5, 2023.

What is hospital-acquired pneumonia (HAP)?

HAP is a lung infection that can develop while you are in the hospital. HAP occurs 48 hours or more after you are admitted. Your lungs become swollen and cannot work well. HAP is usually caused by bacteria. It can become life-threatening.

The Lungs

What increases my risk for HAP?

  • Being on a ventilator (machine that breathes for you)
  • Long-term lung disease
  • A weak immune system
  • Recent surgery
  • Older age (older than 60) or very young age (infants and young children)
  • Being fed through a nasogastric (NG) tube

What are the signs and symptoms of HAP?

  • Cough that may bring up green, yellow, or bloody mucus
  • Fever, chills, or severe shaking
  • Shortness of breath or wheezing
  • Pain in your chest or back when you breathe in or cough
  • Loss of appetite
  • Fast heartbeat
  • Trouble thinking clearly

How is HAP diagnosed?

Your healthcare provider will listen to your lungs for abnormal sounds. You may also need any of the following:

  • Blood tests are used to check for infection.
  • An x-ray or CT scan may show infection, and how well your lungs are working. They may also show other problems, such as fluid around your lungs. You may be given contrast liquid to help your lungs show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • A sputum sample may be tested for the germ that is causing your illness. It can help your healthcare provider choose the best medicine to treat the infection.

How is HAP treated?

  • Medicines will be given to help fight a bacterial infection. You may also be given medicines to decrease swelling, and to help you cough up mucus. You may also need medicines to help open your airway so you can breathe more easily.
  • Deep breathing and coughing helps open the deeper airways in your lungs. Coughing helps to bring up mucus from your lungs.
  • Breathing treatments may help open your airway so you can breathe easier. A machine is used to change liquid medicine into a mist. You will breathe the mist into your lungs through tubing and a mouthpiece. Inhaled mist medicines act quickly to relieve your symptoms.
  • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.
  • A thoracentesis is a procedure used to remove extra fluid that is between your lung and chest wall. You are given numbing medicine, and then a needle is put between 2 of your ribs. The extra fluid is pulled out through the needle and sent to the lab for tests. These tests will help your healthcare provider plan your treatment. You may find it easier to breathe when the fluid is removed.

What can I do to prevent the spread of germs?

  • Wash your hands often. Use soap, and wash for at least 20 seconds. Rinse with warm, running water for several seconds. Then dry your hands with a clean towel or paper towel. Use hand sanitizer that contains alcohol if soap and water are not available. Wash your hands several times each day. Wash after you use the bathroom, change a child's diaper, and before you prepare or eat food. Do not touch your eyes, nose, or mouth without washing your hands first.
  • Cover a sneeze or cough. Use a tissue that covers your mouth and nose. Throw the tissue away in a trash can right away. Use the bend of your arm if a tissue is not available. Wash your hands well with soap and water or use a hand sanitizer.
  • Stay away from others while you are sick. Avoid crowds as much as possible.
  • Ask about vaccines you may need. A pneumonia vaccine can help lower your risk for pneumonia. The vaccine may be recommended every 5 years, starting at age 65. Other vaccines can help lower the risk for infections that can become serious for a person who has pneumonia. Get a flu vaccine each year as soon as recommended, usually in September or October. Get a COVID-19 vaccine and booster as directed. Your healthcare provider can tell you if you should also get other vaccines, and when to get them.

Call your local emergency number (911 in the US) if:

  • You cough up blood.
  • You have more trouble breathing, or your breathing seems faster than normal.

When should I seek immediate care?

  • Your symptoms return.
  • You are confused and cannot think clearly.
  • Your lips or fingernails turn blue.

When should I call my doctor?

  • You have a fever and chills.
  • Your cough does not go away or comes back.
  • You feel very tired or weak, or are sleeping more than usual.
  • You cannot eat or have loss of appetite, nausea, or vomiting.
  • You are urinating less, or not at all.
  • Your heart or pulse beats more than 100 times in 1 minute.
  • You have questions about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.