A 25 year old female presents with pain and tenosynovitis of the wrists and ankles, and ahralgias of other joints. She notes two prior episodes similar to the present one. She just had her menstrual period during the previous week. Physical examination reveals ulcerated lesions overlying the wrists and ankles. These symptoms are likely due to deficiency of which of the following?

Complement (C6-C8) components. This patient has disseminated gonococcemia. Gonococcal ahritis and tenosynovitis typically involve both the upper and lower extremities equally.Vesicular skin lesions are characteristic of disseminated gonococcal disease. Females are at paicular risk of gonococcemia during menstruation, since sloughing of the endometrium allows access to the blood supply, necrotic tissue enhances the growth of Neisseria gonorrhoeae, and there is an alteration of the pH. Patients who have a C6-C8 deficiency have an increased risk of disseminated gonococcemia and tend to have multiple episodes. These patients are also at risk for bacteremia from Neisseria meningitidis.