Here we present a 24-yr-old man with PNH, who had received ravulizumab, a complement component 5 (C5) inhibitor, for three years, with subsequent development of disseminated gonococcal infection.He presented with acute onset of fever up to 41.2 C three days prior to this admission, along with severe headaches, sore throat, rhinorrhea, and mild exertional dyspnea. Arthralgias of the right knee and left ankle were also reported.To prevent meningococcal infection, he had received meningococcal ACYW-135 vaccine at the time when treatment with ravulizumab was initiated.Blood examinations revealed anemia (10.7 g/dL) and a normal white blood-cell count (6.1 103/mL).Other biochem. tests were normal except for an elevated C-reactive protein level (12.9 mg/dL).Cerebrospinal fluid anal. revealed no pleocytosis and normal glucose and lactate dehydrogenase levels.Our case highlights that gonococcal infection should be included in the etiol. of disseminated infections in patients with PNH who receive terminal complement monoclonal antibody and have unprotected sex.Because of its overlapping symptoms with acute retroviral syndrome,6 counseling for HIV testing and prevention should be provided for individuals with unprotected sex and sexually transmitted infections.