Hospital-Acquired Pneumonia: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hospital-Acquired Pneumonia?
A pulmonologist (a lung doctor) or an infectious disease doctor (a doctor who treats infections) often helps care for hospital-acquired pneumonia, along with the hospital care team. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hospital-acquired pneumonia?
Hospital-acquired pneumonia is an infection of the lungs that starts during a hospital stay. Pneumonia is an infection in one or both lungs. It causes the air sacs of the lungs to fill with fluid or pus. Hospital-acquired pneumonia can be very severe, and sometimes it can be fatal.
Another name for it is nosocomial pneumonia. A ventilator is a machine that helps a person breathe. Pneumonia that starts in a person on a ventilator is called ventilator-associated pneumonia.
Symptoms
In older adults, the first sign may be mental changes or confusion. Older adults and people with serious illnesses or weak immune systems may have fewer and milder symptoms.
Other symptoms may include:
- A cough with greenish or pus-like phlegm (sputum).
- Fever and chills.
- A general ill feeling or uneasiness.
- Loss of appetite.
- Nausea and vomiting.
- Sharp chest pain that gets worse with deep breathing or coughing.
- Shortness of breath.
- Lower blood pressure.
- A fast heart rate and fast breathing.
Causes and who gets it
Many different germs can cause pneumonia. Bacterial, viral, and fungal infections can all cause it. Germs in a hospital are often more dangerous and harder to treat than germs outside. People in the hospital are often very sick and cannot fight off germs well. Health care workers can also pass germs from their hands, clothes, or instruments from one person to another.
You are more likely to get it in the hospital if you:
- Have a weak immune system from cancer treatment, certain medicines, or severe wounds.
- Have long-term (chronic) lung disease.
- Breathe saliva or food into your lungs because you are not fully alert or have swallowing problems, for example after a stroke.
- Are older, or have many other diseases.
- Have poor nourishment.
- Are in the hospital for a long time or in the intensive care unit (ICU).
- Are on a ventilator.
How doctors diagnose it
If your health care provider suspects pneumonia, tests will be ordered. These tests can include a chest x-ray or a CT scan of the chest to check the lungs. Blood cultures can show whether the infection has spread to the blood. Sputum tests can show which germs are causing the pneumonia. Pulse oximetry and arterial blood gases measure the oxygen level in the blood. In some cases, a bronchoscopy is used to take tissue samples directly from the lungs.
Treatment
Treatment may include antibiotics given through a vein (IV) to treat the lung infection. The type of antibiotic depends on the bacteria causing the infection. Oxygen and lung treatments can help you breathe better and loosen thick mucus. In more severe cases, a ventilator may support breathing through a tube or a mask.
Hospital-acquired pneumonia can be life-threatening, and long-term lung damage may occur. People with other serious illnesses do not recover as well as people who are not as sick.
Some steps can lower the risk:
- Wash your hands often. Visitors should also take steps to prevent spreading germs, and should stay home if sick.
- Keep your immunizations up to date.
- Vaccines can help prevent pneumonia caused by pneumococcal bacteria or the flu virus.
- After surgery, take deep breaths and move around as soon as you can to help keep your lungs open.
- Ask health care providers to clean their hands before they touch the patient or equipment.
- For a patient on a ventilator, ask about raising the head of the bed and when breathing without the ventilator can be tried.
- Patients who smoke get more infections, so ask about quitting before surgery.
When to see a doctor
Pneumonia that starts in the hospital can be very severe, so tell your nurse or doctor about any new symptoms. After you leave the hospital, see a provider if you have symptoms of pneumonia, because people at risk for complications may need treatment in a hospital.
Call 911 or go to the emergency room if you have severe trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, or a sudden change in mental state.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your history after a hospital stay, check on symptoms, and help you follow your care team's instructions. They can also refer you to a lung or infectious disease specialist if needed.
Common questions
Is hospital-acquired pneumonia serious?
Yes, it can be very serious. It can be life-threatening, and long-term lung damage may occur.
Who is more likely to get hospital-acquired pneumonia?
People who are very sick, older, in the ICU, or on a ventilator are more likely to get it. Having a weak immune system or long-term lung disease also raises the chance.
How is hospital-acquired pneumonia treated?
It is treated mainly with antibiotics, often given through a vein (IV). Some people also need oxygen, and a few need a ventilator to help them breathe.
Can hospital-acquired pneumonia be prevented?
Yes, there are ways to lower the risk. Washing hands often is the best way to stop the spread of germs.
Sources
- MedlinePlus - Hospital-acquired pneumonia (Medical Encyclopedia)
- Centers for Disease Control and Prevention - Ventilator-associated Pneumonia Basics
- MedlinePlus - Pneumonia
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
