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
- 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.
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
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