{"id":25981,"date":"2025-12-17T12:43:18","date_gmt":"2025-12-17T12:43:18","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=25981"},"modified":"2025-12-17T13:06:34","modified_gmt":"2025-12-17T13:06:34","slug":"chronic-symptoms-after-infection-clinic","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/chronic-symptoms-after-infection-clinic\/","title":{"rendered":"Chronic Symptoms after Infection Clinic"},"content":{"rendered":"\n<p>Rehabilitation Medicine consultants have depth and breadth of knowledge through formal medical training and experiential knowledge to assist individuals holistically address symptoms diagnostically and prognostically to minimise illness and optimise health, wellbeing and quality of life. The service is rehabilitative and time-limited.&nbsp;<\/p>\n\n\n\n<p>It is a Lothian-wide service for patients who have been\u00a0<em>given, and accepted,\u00a0<\/em>a diagnosis of Long Covid, ME\/CFS or Post-Viral Fatigue Syndrome. The service is based at the Cunningham Unit, Astley Ainslie Hospital and works closely with a multi-professional team including specialists in speech and language, physiotherapy, occupational therapy, psychology and the Lothian Work Support Service.<\/p>\n\n\n\n<p>Baseline investigations and <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/RM-CSI-referral-form-and-criteria-v2-161225.docx\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/RM-CSI-referral-form-and-criteria-v2-161225.docx\" target=\"_blank\" rel=\"noreferrer noopener\">referral form criteria<\/a> should be met and investigations with other services completed prior to referral<strong>.\u00a0 Please ensure patient acknowledgement that referral to the clinic is not for further clinical investigation or the prescription of unlicensed medication\/ treatments. <\/strong><\/p>\n\n\n\n<p>Please also see recognised clinical investigation pathways of relevance below:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Post COVID breathlessness pathway including\u00a0<\/strong>\u00a0when pulmonary embolism is suspected;\u00a0<a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Respiratory-Post-Covid-Syndrome-v10.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Respiratory-Post-Covid-Syndrome-v10.pdf<\/strong><\/a>\u00a0\u00a0\u00a0<\/li>\n\n\n\n<li>Not all Post-Covid breathlessness is respiratory in nature:\u00a0<ul><li>See\u00a0<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/cardiology\/cardiac-investigations-for-breathless-patients\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Cardiac Investigations for Breathless Patients \u2013 RefHelp<\/strong><\/a><\/li><\/ul>\n<ul class=\"wp-block-list\">\n<li>Consider dysautonomnia or POTS.\u00a0 See RefHelp page on PoTS here:\u00a0<strong><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/cardiology\/postural-tachycardia-syndrome-pots\/\" target=\"_blank\" rel=\"noreferrer noopener\">Postural Tachycardia Syndrome (PoTS) \u2013 RefHelp<\/a><\/strong>\u00a0and \u00a0<strong><a href=\"https:\/\/www.potsuk.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">Home \u2013 PoTS UK<\/a><\/strong><\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Chronic spontaneous urticaria (and mast cell activation syndrome)\u00a0<\/strong><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/immunology\/chronic-spontaneous-urticaria\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Chronic spontaneous urticaria \u2013 RefHelp<\/strong><\/a><\/li>\n\n\n\n<li>Patients with ongoing fevers &gt;38<sup>o<\/sup>C or symptoms of infection of more than 3 weeks duration, documented in a temperature diary, where no other explanation for the fever is apparent, especially if the patient is immunocompromised, should be referred to<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/infectiousdiseases\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>\u00a0Infectious Diseases<\/strong><\/a><\/li>\n\n\n\n<li>Patients with symptoms more suggestive of a possible cancer diagnosis (such as lymphadenopathy or unexplained weight loss) should be urgently referred via the appropriate USOC Sci Gateway pathway see: \u00a0<a href=\"https:\/\/www.gov.scot\/publications\/summary-scottish-referral-guidelines-suspected-cancer-2025\/documents\/\" target=\"_blank\" rel=\"noreferrer noopener\">Supporting documents &#8211; Summary: Scottish Referral Guidelines for Suspected Cancer 2025 &#8211; gov.scot<\/a><\/li>\n\n\n\n<li>GPs can refer directly for CT scan of the chest \/ abdomen \/ pelvis for those with non-specific features concerning for malignancy\u00a0\u00a0\u00a0<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/paediatric-radiology\/gpaccesstoctforsuspectedcancernoclinicallyobviousprimary\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>GP Access to CT for Suspected Cancer (No Clinically Obvious Primary) \u2013 RefHelp<\/strong><\/a><\/li>\n\n\n\n<li>Please note \u2013\u00a0<strong>Digital support pathway for long COVID is no longer available<\/strong><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>AH &amp; MA 17\/12\/25<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\"><strong>Who can\u00a0 Refer<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>GP<\/li>\n\n\n\n<li>ME\/CSF service staff members<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><\/h4>\n\n\n\n<p>Individuals with a clear diagnosis of Long Covid\/ME-CFS* (<em>confirmed by undertaking a full history, examination and baseline investigations in line with <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng206\/chapter\/Recommendations#diagnosis\" target=\"_blank\" rel=\"noreferrer noopener\">Recommendations | Myalgic encephalomyelitis (or encephalopathy)\/chronic fatigue syndrome: diagnosis and management | Guidance | NICE<\/a> and\/or <a href=\"https:\/\/www.nice.org.uk\/guidance\/ng188\" target=\"_blank\" rel=\"noreferrer noopener\">Overview | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE<\/a><\/em>) \u2013 who are seeking to explore and holistically address symptoms diagnostically and prognostically to minimise illness, optimise wellbeing and quality of life.<\/p>\n\n\n\n<p>* <em>Please consider referring ME\/CSF patients to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/rehabilitation\/chronicfatiguesyndromeme\/me-cfs-chronic-fatigue-rehabilitation-service\/\" target=\"_blank\" rel=\"noreferrer noopener\">Chronic Fatigue Rehabilitation Service: ME-CFS \u2013 RefHelp<\/a> service first.<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients where the diagnosis of ME-CFS is unclear or investigations are ongoing.<\/li>\n\n\n\n<li>Patients should not be referred to this service for confirmation of diagnosis.<\/li>\n\n\n\n<li>Patients seeking further investigations or the prescription of unlicenced medications.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>How to refer:<\/strong><\/h4>\n\n\n\n<p>To refer to this service please complete the <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/RM-CSI-referral-form-and-criteria-v2-161225.docx\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/RM-CSI-referral-form-and-criteria-v2-161225.docx\" target=\"_blank\" rel=\"noreferrer noopener\">referral form criteria<\/a> and <strong>send by email to: <\/strong><a href=\"mailto:loth.csireferrals@nhs.scot\" target=\"_blank\" rel=\"noreferrer noopener\">loth.csireferrals@nhs.scot<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources &amp; Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/RM-CSI-referral-form-and-criteria-v2-161225.docx\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/RM-CSI-referral-form-and-criteria-v2-161225.docx\" target=\"_blank\" rel=\"noreferrer noopener\">Chronic Symptoms after Infection Clinic referral form criteria<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Rehabilitation Medicine consultants have depth and breadth of knowledge through formal medical training and experiential knowledge to assist individuals holistically address symptoms diagnostically and prognostically to minimise illness and optimise health, wellbeing and quality of life. The service is rehabilitative and time-limited.&nbsp; It is a Lothian-wide service for patients who have been&nbsp;given, and accepted,&nbsp;a diagnosis<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"class_list":["post-25981","page","type-page","status-publish","hentry"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"aparnaamanna","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/aparnaamanna\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Rehabilitation Medicine consultants have depth and breadth of knowledge through formal medical training and experiential knowledge to assist individuals holistically address symptoms diagnostically and prognostically to minimise illness and optimise health, wellbeing and quality of life. The service is rehabilitative and time-limited.&nbsp; It is a Lothian-wide service for patients who have been&nbsp;given, and accepted,&nbsp;a diagnosis","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25981","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=25981"}],"version-history":[{"count":4,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25981\/revisions"}],"predecessor-version":[{"id":25993,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25981\/revisions\/25993"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=25981"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=25981"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}