The Regional Infectious Diseases Unit (RIDU) offers specialist inpatient and outpatient management of complex infection in adults. This includes management of blood born viruses (HIV, HBV and HCV), non-pulmonary tuberculosis, and review of returning travellers or migrants with ongoing health concerns related to their travel.
Depending on epidemiology, and after exclusion of non-infective causes, RIDU offers investigation of patients with fever of unknown origin or ongoing symptoms suggestive of infection, such as night sweats, weight loss and lymphadenopathy.
RIDU oversees the NHS Lothian Travel Clinics which provide a specialist pre-travel health service. Locations and opening times can be found on the NHS Lothian Travel Clinic website. Patients can purchase all necessary vaccines and malaria prophylaxis at these clinics as well as receive up-to-date travel advice. Patients can self-refer to this service, but attendance is by appointment only.
C.M & N.B 03-06-25
Who to refer:
It is appropriate to refer those with:
- Pyrexia of unknown origin, after consideration of non-infective causes
- Ongoing symptoms of infection, such as night sweats, weight loss and lymphadenopathy, following exclusion of non-infective causes – please also see RefHelp’s night sweats page
- Active blood-borne viral infection
- Fever or other infective symptoms following travel
- Suspected or confirmed non-pulmonary tuberculosis (pulmonary TB should be referred to Respiratory Medicine)
- Mycobacterial infection in people living with HIV
- Unexplained eosinophilia, where parasitic infection is suspected
- Specific conditions outlined in these pages
Please note, this list is not exhaustive and the RIDU team is happy to provide advice or review for any person where complex or recurrent infection is suspected.
Who not to refer:
Do not refer patients:
- Asymptomatic contacts of individuals with active TB infection/questions regarding TB screening – these should be referred directly to the TB specialist nurses at loth.tbservice@nhs.scot
- People with ME/chronic fatigue syndrome – Infectious Diseases does not offer a service for the diagnosis or management of ME-CFS. Those who meet the diagnostic criteria can be referred directly for rehabilitation. If there are diagnostic uncertainties, please refer to the specialist most aligned to the clinical system involved, and only refer to Infectious Diseases if ongoing symptoms are suggestive of active infection: please see the ME-CFS page for further detail.
- Stable patients requiring intravenous antibiotic therapy for skin and soft tissue infection or multi-drug resistant urinary tract infections should be referred directly to OPAT.
- For patients with recurrent UTIs, not requiring immediate intravenous therapy via OPAT, please consider the advice available on the Urology Recurrent UTI page. This also details the referral route to the Recurrent UTI clinic (Urology) for those with recurrent UTIs despite recommended interventions.
Patients should not be referred to request unconventional treatments not currently recommended in the NHS or to discuss the results of unconventional or non-UK accredited tests carried out in the private sector or abroad.
How to refer:
In general, non-urgent ID advice and outpatient review should be requested via SCI Gateway.
Urgent ID advice is available by contacting the on-call Infectious Diseases doctor via WGH switchboard.
The Infectious Diseases email inbox should generally not be used by primary care to seek advice – please use SCI Gateway.
