A 30-year-old male presented with fever with chills and migratory polyahralgias. On examination some skin lesions were noted. Aspiration was done from the painful left knee and subjected to gram-staining. The patient repoed of similar infections in the past which led to frequent hospitalizations. Which of the following should be screened for in the above patient:-
Correct Answer: Total hemolytic complement deficiency
Description: This is a case of disseminated gonococcal infection in the setting of total hemolytic complement deficiency. 1st image shows the skin lesions of disseminated gonococcal infection which occur typically on the arms or legs, have a red base, and are small, slightly painful, and often pustular Gram stain shows the gram-negative diplococci both intracellular and extracellular along with neutrophils. Patient deficient in C5-C9 complement are predisposed to recurrent neisserial infections due to lack of the membrane attack complex formation. Neutrophil quantitative or qualitative (Chediak-Higashi syndrome) does not predispose to gonococcal infections. Clonally defective lymphocyte populations also do not predispose to the gonococcal infections.
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