Hello, Welcome to Healthcare Magic. I have read your question fully and understand your concerns. When a patient has had any major surgery, their immunity is a bit low as they are in the recovery stage. I this circumstance, they are easily prone to contract infections like pneumonia or urine infections. Further, as your relative is in the hospital recovering from spinal surgery, she may have contracted the pneumonia from other patients in the hospital (called hospital acquired pneumonia) .From what you have mentioned, it looks like your family member is having delirium. Delirium is an acute confusional state which can occur due to many reasons. Infections like pneumonia are one of the common causes of delirium. Pneumonia if worsened can lead to sepsis which can cause delirium and other multi organ problems. I am not sure when she had the back surgery, but if it was recent, then the surgery can contribute to delirium too. Certain drugs can cause delirium – painkillers that she may be given for her spinal surgery like benzodiazepines/opoids like codeine, morphine or tramadol, any blood pressure medication she is on could all contribute to delirium. Simple reasons like constipation in elderly can also cause delirium. I would advise you to ask her doctor to come and see her. They would assess her thoroughly, do the necessary investigations like blood tests and scans and may put her on the appropriate management. If any medicines need changing they may change them, if her pneumonia is not settling then she may be put on stronger antibiotics. She may even need hospital admission if her pneumonia has worsened or if she has sepsis. I wish her a quick recovery. I hope this answer has helped you. Thank you Regards Dr Sunita Sayammagaru