Hospital-acquired pneumonia (HAP) or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48–72 hours after being admitted. It is thus distinguished from community-acquired pneumonia. It is usually caused by a bacterial infection, rather than a virus.HAP is the second most common nosocomial infection (after urinary tract infections) and accounts for 15–20% of the total. It is the most common cause of death among nosocomial infections and is the primary cause of death in intensive care units.HAP typically lengthens a hospital stay by 1–2 weeks. Signs and symptoms
New or progressive infiltrate on the chest X-ray with one of the following:
Fever > 37.8 °C (100 °F)
Purulent sputum
Leukocytosis > 10,000 cells/μlIn an elderly person, the first sign of hospital-acquired pneumonia may be mental changes or confusion. Other symptoms may include:

A cough with greenish or pus-like phlegm (sputum)
Fever and chills
General discomfort, uneasiness, or ill feeling (malaise)
Loss of appetite
Nausea and vomiting
Sharp chest pain that gets worse with deep breathing or coughing
Shortness of breath
Decreased blood pressure and fast heart rate

Types
Bacterial pneumonia: The majority of cases related to various rod shaped gram-negative organisms (52%) and Staphylococcus aureus (19%), usually of the MRSA type. Others are Haemophilus spp. (5%). In the ICU results were S. aureus (17.4%), Pseudomonas aeruginosa (17.4%), Klebsiella pneumoniae and Enterobacter spp. (18.1%), and Haemophilus influenzae (4.9%). Viral pneumonia: influenza and respiratory syncytial virus and, in the immunocompromised host, cytomegalovirus – cause 10–20% of infections.
Benign paroxysmal vertigo of childhood is an uncommon neurological disorder which presents with recurrent episodes of dizziness. The presentation is usually between the ages of 2 years and 7 years of age and is characterised by short episodes of vertigo of sudden onset when the child appears distressed and unwell. The child may cling to something or someone for support. The episode lasts only minutes and resolves suddenly and completely. It is a self-limiting condition and usually resolves after about eighteen months, although many go on to experience migrainous vertigo (or vestibular migraine) when older.Benign paroxysmal vertigo of childhood is a migrainous phenomenon with more than 50% of those affected having a family history of migraines affecting a first-degree relative. It has no relationship to benign paroxysmal positional vertigo which is a different condition entirely. == References ==