# Oro-Pharyngeal Candidiasis in Two Dengue Patients

## TL;DR

Two severe dengue patients developed oral candidiasis, a rare complication not previously reported, suggesting a need for increased clinical awareness.

## Contribution

First reported cases of dengue-associated oral/oro-pharyngeal candidiasis in patients without typical risk factors.

## Key findings

- Two dengue patients presented with pseudomembranous candidiasis without known immunosuppression.
- Both cases improved with conservative management and oral nystatin.
- The findings suggest a possible link between dengue and opportunistic fungal infections.

## Abstract

Dengue, a prevalent arboviral disease, has witnessed a resurgence in India, with outbreaks frequently reported. However, dengue-associated oral (oro-pharyngeal) candidiasis (DAOC) was never reported. We present two severe dengue cases with oral/oro-pharyngeal pseudomembranous candidiasis. Case 1 of a young man without any comorbidities or abuse or immunosuppression presented with fever, headache, altered sensorium, throat pain on recovery, and laboratory reports confirmed dengue with leukopenia, thrombocytopenia, and severe hepatic involvement with oro-pharyngeal candidiasis. Similarly, case 2 of a middle-aged man with a history of smoking and diabetes presented with fever, gum bleeding, and throat pain, later confirmed to be dengue NS1 positive with thrombocytopenia, and mild-moderate hepatic involvement along with oral-oro-pharyngeal candidiasis. Both cases showed improvement with conservative management and oral nystatin suspension. These cases prompt consideration of superadded candida infections in dengue patients, emphasizing the need for further study and clinical vigilance.