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Hospital Acquired Pneumonia


What is hospital acquired pneumonia?

Hospital acquired pneumonia (HAP) is a lung infection that you get while you are in the hospital. HAP occurs 48 hours or more after being admitted to the hospital. 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
  • Weak immune system
  • Recent surgery
  • Older age (older than 60) or very young age (infants and young children)
  • Being fed through a nasogastric feeding 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
  • Fatigue and loss of appetite
  • Fast heartbeat
  • Trouble thinking clearly (especially in elderly people)

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. 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. Use soap and water every time. Rub your soapy hands together, lacing your fingers. Wash the front and back of your hands, and in between your fingers. Use the fingers of one hand to scrub under the fingernails of the other hand. 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. 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. Talk to your healthcare provider about your vaccine history. He or she will tell you which vaccines you need, and when to get them.
    • Get the influenza (flu) vaccine as soon as recommended each year. The flu vaccine is available starting in September or October. Flu viruses change, so it is important to get a flu vaccine every year.
    • Get the pneumonia vaccine if recommended. This vaccine is usually recommended every 5 years. Your provider will tell you when to get this vaccine, if needed.

What are the risks of HAP?

You may have breathing problems, or the infection can spread to other areas of your body. Pus or extra fluid may collect in the space around your lungs, or your lungs may get damaged. You may not get enough oxygen if your lungs are swollen or filled with fluid. Low oxygen can cause damage to other body organs, such as your kidneys, heart, and brain. HAP can become life-threatening.

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 comes back or does not go away
  • 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.