Atypical Manifestation of Oral Candidiasis in Patient with Aplastic Anemia

Candidiasis is an opportunistic fungal infection predominantly caused by Candida species, which can manifest in immunocompromised individuals such as those with aplastic anemia. Aplastic anemia, characterized by bone marrow failure, significantly increases susceptibility to infections, with fungal infections being a leading cause of mortality. Oral candidiasis is one of the most common manifestations, and it typically presents as white pseudomembranes. However, atypical presentations can occur. We report a case of a 26-year-old male with aplastic anemia who presented with general weakness, fever, and painful swallowing. On examination, a blackish plaque was observed on his palate. Laboratory tests, including palatal tissue smear, histological examination, and culture, confirmed an infection of Candida tropicalis. This unusual blackish manifestation of oral candidiasis, resembling mucormycosis, has not been previously described in the literature. The patient was treated with intravenous fluconazole, leading to complete resolution of the oral lesions within 11 days. Through this case, we underscore the importance of recognizing atypical presentations of common infections, particularly in immunocompromised patients, and highlight the need for thorough diagnostic evaluation to guide appropriate antifungal therapy.