# Recurrent Gonococcemia Reveiling X-linked Properdin Deficiency: A Novel Case Report

## TL;DR

A patient with X-linked properdin deficiency experienced recurrent gonococcal infections, highlighting the need to consider complement pathway deficiencies in such cases.

## Contribution

This is the first reported case linking X-linked properdin deficiency to disseminated gonococcal infections.

## Key findings

- X-linked properdin deficiency can lead to recurrent disseminated gonococcal infections.
- Properdin deficiency is rarely considered during initial infection episodes despite its role in complement pathway deficiencies.
- The case emphasizes the importance of investigating complement pathway deficiencies in recurrent infection cases.

## Abstract

We present a unique case involving a patient who was diagnosed with X-linked properdin deficiency after 2 episodes of disseminated gonococcal infections 1 year apart. Although this deficiency is well-documented for its association with meningococcemia, its correlation with disseminated gonococcal infections (DGI) has not been previously reported. Recurrent DGI cases reported in the literature with identified cause are mostly associated with acquired or congenital complement pathway deficiencies. However, properdin deficiency is rarely screened for during a first episode. Our case not only highlights the clinical presentation that should raise suspicion of DGI but also underscores the importance of investigating the alternative complement pathway in such cases. At a time when gonococcal resistance is increasing, it is essential to consider existing strategies for preventing these infections, including vaccinations.