Over the past couple of weeks, my immune system has been struggling to fight off a cold. It’s been unpleasant, as all colds are. But over the same period—in defiance of my plight—I’ve been waging my own war against immune systems, thanks to Pathogenic, a new roguelite twin-stick shooter from developer Aberrant Labs.
As I’ve downed endless shots of ineffective cough syrup, I’ve done little else with my free time than repeatedly take on the role of a bodily invader. And let me tell you: Being on the enemy’s side is much more fun. Really fun, as it turns out.
Action roguelites are a dime a dozen these days, and it takes something special to stand out. So as quiet Internet whispers turned into widespread cacophonous praise—the little indie game quickly racked up 100,000 sales and an “overwhelmingly positive” review score on Steam—I set aside my default skepticism and gave it a shot.
I’m glad I did.
Under the skin
A brief introductory video sets the scene: A hapless lab assistant drops a vial, and wouldn’t you know it, the poor guy has a cut on his ankle. That’s where you come in. As a lone pathogen, you work your way through his body, starting in the skin and then moving on to the intestines, liver, stomach, lungs, and finally heart. Each zone culminates in a boss fight, and you’re continually upgrading your build along the way to keep pace with the stages’ increasing difficulty. Defeat the dreaded heart to kill your host and claim victory (or forge on to the secret brain boss for extra bragging rights).
What this means in gameplay terms is twin-stick shooting through a series of rooms filled with pesky macrophages and T cells, or even rival pathogens (don’t steal my kill!). Combat is fast and frequently demanding; you strafe and dodge around bullet-hell projectiles and hazards with the left stick while trying to keep your weapons trained on enemies with the right.
The setup is very Binding of Isaac—for this author’s money, one of the best video games of all time. In addition to combat rooms, each procedurally generated zone contains a few safe spaces that offer various powerups, either free or purchasable with in-game currency, and you’ll want to scour the level for these and other goodies before taking on the zone’s boss.
Here’s where the game gets interesting. Your little parasite houses various slots to plug in your powerups, and each upgrade affects any weapons (or other upgrades) to which it’s attached. You can freely swap upgrades in and out as you get new ones. Add effects like fire or electric damage to your attacks, slot in new projectile or melee weapons, or even pick up active abilities to fill out your kit. Some upgrades allow you to “overcharge” and give bonuses to other nodes in your system when certain requirements are met. The game definitely has more than a little cell-stage Spore in it.
Ah nuts, it’s mutating
The magic is in how all these upgrades interact. The Binding of Isaac is known for its many and varied “synergies”—items that, when combined, produce surprising and delightful effects. That’s what Pathogenic is all about: creating game-breaking, frame-rate-hobbling builds that let you bully the game’s enemies into submission. Here, though, those synergies are modular and customizable.
Say you’re using a weapon that spits out grenades. Cool, but basic. But then you attach an upgrade that makes those grenades grow in size and power over time. And then you add an effect that causes electricity to chain between them. Not content, you buff the damage of the electricity or infuse some other effect into it. Then, just for good measure, you make the whole thing home in on enemies.
There are an impressive number of interactions, and the game revels in piquing your curiosity. So many times, when connecting items, I’ve thought, “Surely this won’t work—OH MY GOD, IT DOES.”
The most satisfying part of roguelites isn’t becoming powerful because the numbers went up; it’s becoming powerful due to your own cleverness. Pathogenic is a toybox that rewards experimentation.
Enemies drop DNA helixes on death; collect them to level up and mutate—i.e., choose between four random passive effects. Every few levels, you’ll be able to evolve into a newly configured pathogen with more slots for upgrades. Different pathogens offer different ways to build your character, including one that starts with very limited slots but lets you add them exactly where you want over time.
Between runs, you’ll spend the game’s meta-currency (mostly obtained from bosses) to unlock permanent upgrades on a skill tree, making subsequent runs a bit smoother. Each pathogen has its own tree; I’ve been focusing mostly on one for now since progression is slow but steady. There’s a ton to unlock, and completionists should be kept busy for quite some time.
Infectious fun
All the game’s content is rich in theme—the items have scientific-sounding names, and the stages pose thematically appropriate hazards. In the lungs, for instance, wind pushes you around, and the intestine stage features a long, winding hallway. The visuals are excellent, the music rocks, and the sound design is punchy.
You and your enemies have what the developer calls “soft body physics,” meaning you squish and squash as you ram into each other and into walls. Since many enemies don’t deal damage on contact, this opens up some interesting gameplay avenues, but mostly it’s just fun.
Despite my praise, there are a few things to keep in mind. If you’re not into roguelites—maybe the whole “permadeath” thing turns you off—this game won’t be for you. And not every run will be a banger, of course; there’s plenty of randomness involved, as befits the genre. Making the best of what you get, and occasionally surprising yourself with a wacky build, is all part of the fun.
The game is also not easy; there’s a lot of bullet hell here, and many rooms are tight and filled with hazards and enemies. I’ve had more than a few frustrating deaths due to so much going on in small spaces, though I’m learning how to avoid them the more I play. Overwhelming visual effects can sometimes be an issue, but you can tone down the clutter in the settings if it gets to be too much.
Still, any death just makes it all the sweeter when you return next time with an overpowered build and delete entire rooms as you walk into them.
The game plays great on the Steam Deck, essentially a requirement for me these days. When things get chaotic and effects fill the screen in the later stages, there can be some slowdown, but nothing has been showstopping for me. It’s currently available only on PC, though, so console players are out of luck.
But the best news might be that the game is scandalously underpriced at $10. If you like action roguelites at all, this is a no-brainer pickup.
Being sick is miserable, but I have to admit, I’ve gained some newfound respect for the little guys that put me through this. May they all see a game-over screen soon.







