Recurrent infection assessment

What is a recurrent infection assessment?

Most people get coughs, colds and other infections from time to time, and this is normal. A recurrent infection assessment is for people whose infections stand out as a pattern — they are too frequent, too severe, last too long, keep coming back, or are caused by unusual germs. Clinicians sometimes summarise this as 'SPUR': severe, persistent, unusual or recurrent infections.

The assessment is an appointment, usually with a consultant immunologist, to work out why the infections are happening and whether the immune system is involved. There are many possible reasons, and most turn out not to be an immune deficiency.

The immunologist takes a detailed history of the infections, examines you, and decides which tests, if any, are needed. These may include blood tests for antibody (immunoglobulin) levels and how well you respond to vaccines, alongside looking for other explanations such as a local cause (for example sinus or lung problems), allergy, smoking, diabetes, or a medicine that affects immunity.

It is important to be clear about what the assessment can and cannot do. It can identify treatable causes — immune or otherwise — and reassure the many people whose immune system is normal. It cannot promise an answer for everyone, and a normal result does not mean you will never get another infection.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your test

• Make a timeline of your infections: how often, how severe, where in the body, which germs if known, and how each was treated.
• Note hospital admissions, courses of antibiotics, and any infections needing intravenous (drip) treatment.
• Bring details of any family history of immune problems or recurrent serious infections.
• List all your medicines, including steroids or immune-suppressing drugs, and mention smoking and any conditions such as diabetes.
• Bring records of previous blood tests, vaccinations and any earlier specialist letters.
• Note other symptoms such as tiredness, weight loss, diarrhoea, swollen glands or a persistent cough.
• Write down your questions, as the assessment may lead to tests done over time.

What happens

The immunologist takes a detailed history of your infections and general health and examines you. They are looking for whether the pattern is genuinely abnormal, for signs of complications such as lung damage, and for both immune and non-immune causes.

If the history suggests it, you have blood tests — which may include a full blood count and immunoglobulin levels — and you may be given a vaccine, such as the pneumococcal vaccine, with a return visit about four weeks later to check your response. The immunologist also considers explanations such as a local lung or sinus problem, allergy, smoking, diabetes, or a medicine affecting immunity, and may arrange referral to another specialty.

You leave with an explanation of what is being looked for, which tests have been requested, and a follow-up plan. For many people, no serious cause is found and the main outcome is reassurance and sensible prevention advice.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main challenge is that frequent infections are common and usually not due to an immune deficiency, so the assessment is as much about finding other causes and reassuring people as about diagnosing immune disease. Be wary of services that promise to diagnose an immune problem from a single test, or that sell 'immune boosting' tests and supplements. Make sure you understand which tests are being done, what each would change, and how you will be followed up. A severe infection happening now needs urgent care, not a routine appointment.

Published figures to discuss

Frequent infections are common and usually not caused by immune disease, so a single 'success' or 'detection' figure is not meaningful. Tests are used selectively and interpreted with the history. The notes below are broad and for context only.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from the assessment. 'Afterwards' is about completing any tests — including a return visit for vaccine-response testing if needed — waiting for results, and following the plan, which may involve another specialty.

• Not having a complete answer at the first appointment
• A return visit for vaccine-response testing about four weeks after a vaccine
• Being referred to another specialty if the cause lies elsewhere
• Reassurance and prevention advice rather than a diagnosis, for many people
• A plan that develops as results come back

Aftercare

• Complete any requested blood tests, including the return visit for vaccine-response testing.
• Follow any prevention plan, such as vaccines, stopping smoking, or managing conditions like diabetes.
• Keep a record of any new infections and treatments to bring to follow-up.
• Seek medical help promptly for severe infections, as advised for your situation.
• Attend any onward referral, such as to a respiratory or ENT specialist.
• Tell other clinicians about your assessment, especially before vaccines or immune-suppressing treatment.
• Come back for review if your pattern of infections changes.

• Timeline of infections prepared and kept up to date
• Any initial blood tests completed
• Return visit for vaccine-response testing booked if needed
• Family history and medicine list shared
• Smoking, diabetes and other relevant factors mentioned
• Onward referral attended if arranged
• Plan for seeking help with severe infections clear

⚠ Get urgent help if…

• A high fever with feeling very unwell
• A severe or rapidly spreading infection, or one not responding to treatment as expected
• Breathlessness, chest pain or coughing up blood
• Signs of sepsis: confusion, very fast breathing, mottled or pale skin — call 999
• Persistent fevers, drenching night sweats or unexplained weight loss
• Repeated infections needing intravenous antibiotics or hospital admission

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good outcome is a clear view on whether your infections are genuinely abnormal and, where there is a treatable cause — immune or otherwise — a plan that reduces them. For many people, the most valuable result is reassurance that the immune system is working normally, with practical advice on prevention.

The assessment cannot promise an answer for everyone, and some people are left without a single clear cause even after thorough checks. A normal result is reassuring but is interpreted alongside your history, and you should seek review if your pattern changes. A normal assessment does not mean you will never get another infection — it means a serious underlying problem is unlikely.

How long the result remains useful depends on what is found. If a clear cause is identified and treated, the plan stands while that cause is managed. If no cause is found, the reassurance is reasonable but not permanent — you should be reviewed if your infections become more frequent, severe or unusual, because some conditions become apparent over time.

Related tests, treatments or support

A recurrent infection assessment is often combined with input from other specialties depending on the pattern — for example respiratory medicine for recurrent chest infections, ENT for sinus problems, or diabetes care where blood sugar control is relevant. Where an immune deficiency is suspected, it leads into more detailed primary or secondary immunodeficiency assessment.

Follow-up & long-term care

Follow-up is arranged to review any test results and decide on a plan. Initial results come back within days to weeks; vaccine-response and specialised tests take longer. Ask who to contact if you develop a severe infection while your assessment is ongoing, and how to come back if your pattern of infections changes.

• Keep vaccinations up to date as advised
• Manage contributing factors such as smoking, diabetes or chest and sinus conditions
• Continue any preventive treatment as planned
• Report a worsening pattern of infections promptly
• Return for review if infections become more frequent, severe or unusual

Repeat, follow-on and what comes next

• The assessment may need repeating if your pattern of infections changes.
• A normal result is reasonable reassurance but not a permanent guarantee.
• Where an immune cause emerges, the work-up moves on to more detailed immunodeficiency testing.
• Plans are adjusted as new results return or as other causes are treated.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear explanation of which tests are being done and what each would change.
• A named contact and route for results and for severe infections.
• Prevention advice tailored to the likely cause, including vaccines where relevant.
• Onward referral to the right specialty when the cause lies elsewhere.
• A clear plan to return for review if the pattern of infections changes.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Length and complexity of the consultation
• Whether blood tests are needed, and which ones
• Vaccine-response testing, which needs a vaccine and a repeat blood test
• Any specialised immune tests where an immune cause is suspected
• Onward referral to other specialties, such as respiratory or ENT
• Follow-up appointments and any repeat testing

• The consultant's appointment fee
• Which tests are included and the cost of any additional tests
• The cost of the vaccine and the return visit for vaccine-response testing, if needed
• Cost of any onward referral or specialised testing
• Cost of follow-up appointments
• What happens, and what it costs, if no clear cause is found
• Cancellation policy

On the NHS? Recurrent infections are assessed on the NHS when clinically indicated; private appointments may be used for speed or a second opinion.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Is my pattern of infections genuinely abnormal, or within the normal range?
• Which tests are you requesting, and what would each result change?
• Could a lung, sinus, allergy, smoking or diabetes problem be the real cause?
• Do I need vaccine-response testing, and will that mean a return visit?
• If the results are normal, what happens next and when should I come back?
• If you find an immune deficiency, what treatment and monitoring would I need?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for recurrent infection assessment

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Immunodeficiency UK — symptoms and diagnosis UK Primary Immunodeficiency Network (UKPIN) Attending to warning signs of primary immunodeficiency across clinical practice — PMC Evaluation of the 10 warning signs in primary and secondary immunodeficiency — PMC Primary immunodeficiency overview — PMC NHS — Sepsis (urgent help with infection)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.