Introduction Mannose-binding lectin (MBL) plays an important role in innate immunity by mediating phagocytosis and complement-mediated destruction of pathogens. Decreased MBL levels have been associated with an increased susceptibility to herpes simplex virus, influenza A, Pseudomonas aeruginosa, and Staphylococcus aureus. MBL- deficient individuals typically present with upper respiratory tract infections, acute otitis media, or lupus-like symptoms. We present an infant with multiple infections who was diagnosed with MBL deficiency. Case Description This is a 7-week-old term male with a history of failure to thrive and acute otitis media. He was admitted with fever, respiratory distress, and new onset seizures. A respiratory panel was positive for Influenza B, Enterovirus, and Rhinovirus. Physical exam was significant for hepatomegaly and a desquamating rash on his lips, buttocks, and left hand consistent with possible Staphylococcus scalded skin syndrome, treated with antibiotics. An immunodeficiency was suspected because of multiple infections. Laboratory work-up revealed a positive blood culture to MRSA and low mannose-binding lectin levels (initial 11.9 ng/mL, repeat 3 ng/mL - normal range >50 ng/mL). Lymphocyte subsets (T, B and NK cells), quantitative immunoglobulins (IgA, IgM, and IgG), and CH50 were all normal. He was diagnosed with MBL deficiency. Discussion MBL deficiency is a poorly understood disorder of the innate immune system. There have been limited reports of MBL deficiency despite a high prevalence in certain populations. This case highlights the importance of having innate immune system defects in the differential diagnosis for early diagnosis and management of patients with a history of multiple infections. Mannose-binding lectin (MBL) plays an important role in innate immunity by mediating phagocytosis and complement-mediated destruction of pathogens. Decreased MBL levels have been associated with an increased susceptibility to herpes simplex virus, influenza A, Pseudomonas aeruginosa, and Staphylococcus aureus. MBL- deficient individuals typically present with upper respiratory tract infections, acute otitis media, or lupus-like symptoms. We present an infant with multiple infections who was diagnosed with MBL deficiency. This is a 7-week-old term male with a history of failure to thrive and acute otitis media. He was admitted with fever, respiratory distress, and new onset seizures. A respiratory panel was positive for Influenza B, Enterovirus, and Rhinovirus. Physical exam was significant for hepatomegaly and a desquamating rash on his lips, buttocks, and left hand consistent with possible Staphylococcus scalded skin syndrome, treated with antibiotics. An immunodeficiency was suspected because of multiple infections. Laboratory work-up revealed a positive blood culture to MRSA and low mannose-binding lectin levels (initial 11.9 ng/mL, repeat 3 ng/mL - normal range >50 ng/mL). Lymphocyte subsets (T, B and NK cells), quantitative immunoglobulins (IgA, IgM, and IgG), and CH50 were all normal. He was diagnosed with MBL deficiency. MBL deficiency is a poorly understood disorder of the innate immune system. There have been limited reports of MBL deficiency despite a high prevalence in certain populations. This case highlights the importance of having innate immune system defects in the differential diagnosis for early diagnosis and management of patients with a history of multiple infections.