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:-

**Core Concept**
The patient's presentation of recurring fever, chills, migratory polyarthralgias, and skin lesions, along with a history of frequent hospitalizations for similar infections, suggests a chronic autoimmune or immunodeficiency disorder. This clinical scenario is suggestive of a condition that compromises the body's immune response, making it susceptible to recurrent infections.

**Why the Correct Answer is Right**
The patient's symptoms are characteristic of **Neisseria gonorrhoeae** infection, which can cause disseminated gonococcal infection (DGI). DGI is a complication of gonorrhea that occurs when the bacteria spread from the primary site of infection to other parts of the body, including the skin, joints, and bloodstream. The patient's history of frequent hospitalizations for similar infections suggests an underlying immunodeficiency or chronic condition that predisposes them to recurrent infections. The correct answer is related to the patient's likely underlying condition that makes them susceptible to recurrent infections.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not directly related to the patient's presentation of recurrent infections and is not a condition that would typically cause the symptoms described.
* **Option B:** While this option might seem plausible, it is not the most likely underlying condition given the patient's history of recurrent infections. The patient's symptoms are more suggestive of an autoimmune or immunodeficiency disorder rather than a primary hematological disorder.
* **Option C:** This option is a plausible underlying condition, but it is not the most likely given the patient's presentation. The patient's symptoms are more suggestive of a condition that compromises the body's immune response rather than a primary autoimmune disorder.

**Clinical Pearl / High-Yield Fact**
It is essential to consider underlying immunodeficiency or chronic conditions in patients with recurrent infections, as these conditions can significantly impact treatment and management.

**Correct Answer:** C.

✓ Correct Answer: C. Total hemolytic complement deficiency