Infectious Diseases

Who We Are

The Infectious Diseases team is based in Ninewells Hospital, Dundee and comprises of 4 Consultant Physicians who deliver inpatient infection services and advice on investigation and management of clinical infection for all of Tayside.
Our inpatient beds are in ward 42 at Ninewells and urgent outpatients are seen in Ninewells Est Block Outpatient Area.
The team is supported by registrars in ID and medical microbiology, specialist antimicrobial pharmacists and clinical nurse specialists in OHPAT and HIV.
The majority of infections requiring secondary care input need assessed urgently and we would aim to see the majority of patients within 48 hours if well enough to not require emergency admission. Certain chronic infections (e.g. Lyme borreliosis, viral hepatitis etc) are less urgent and can be assessed routinely in outpatient setting.
Patients with sepsis or clearly requiring admission for other reasons should be admitted through standard pathways.

The ID consultant team consists of:
Dr Charis Marwick
Dr Busi Mooka
Dr Nikolas Rae
Dr Lynn Urquhart

Who to refer

We are able to provide advice on all aspects of investigation and management of infection.
Patients with sepsis should be admitted to hospital.

Particular presentations or conditions that should be referred to us for ambulatory assessment:

Cellulitis – not responding to oral treatment but not unwell
Spondylodiscitis - if no neurology / evidence cord compression on imaging
Tuberculosis – suspected or confirmed
Persistent unexplained febrile illness
Fever, suspected infection or eosinophilia following international travel
Infection caused by resistant organisms without oral treatment options (e.g. UTI with ESBL-producing organisms)
HIV infection
Chronic hepatitis B or C
Recurrent infections without adequate explanation
Lyme borreliosis (with positive serology) – particularly if concerns around neurological involvement
Schistosomiasis (positive Schistosoma ELISA) – non-urgent

Antibiotic queries can often be dealt with by Antimicrobial Pharmacy Team via email Tay.antibioticpharm@nhs.scot
Queries about HIV medicines can sent to HIV pharmacist via email Tay.arvservice@nhs.scot

Who not to refer

Abscesses require evaluation by a surgeon with a view to incision and drainage, sub-specialty as follows:

Upper limb - Plastics
Lower limb - Orthopaedics

Abdominal wall - General Surgery
Suspected groin abscess due to injecting drug use - Vascular Surgery

Patients with chronic fatigue often derive little benefit from increased medical input. Management should be as per NICE guidelines - chronic fatigue syndrome.
Bilateral leg changes labelled as cellulitis – bilateral cellulitis is vanishingly rare. Unless clear objective evidence of infection – acute change in one leg/systemic features the patient should be managed as per venous eczema +/- dermatology opinion obtained if appropriate.

How to refer

The three routes of referral include:

SCI-Gateway – for non-urgent advice / referral
E-mail address – Tay.id@nhs.scot – best method for advice required within 24-48h. Checked several times daily Mon-Fri.
On-call page (bleep 5075) – carried by registrar / consultant 9-5 Mon-Fri. For urgent advice / patients requiring urgent assessment +/- admission

Useful resources

NHS Tayside Antibiotic Website With subsections on antimicrobial advice for different specialities. (Primary care links at bottom of page)
ID service inbox Tay.id@nhs.scot
Antimicrobial pharmacy team inbox Tay.antibioticpharm@nhs.scot
HIV team inbox Tay.arvservice@nhs.scot
NICE Guideline – Chronic Fatigue Syndrome