Comparative Analysis of antifungal prophylaxis versus Standard Care in dengue fever
DOI:
https://doi.org/10.5281/zenodo.22812062Keywords:
dengue, antifungal prophylaxis, invasive candidiasis, critical care, secondary infectionAbstract
Background: Severe dengue involves marked lymphopenia and cytokine-driven immune dysregulation, and ICU patients accumulate risk factors, central lines, prolonged antibacterial therapy, ventilation, that predict invasive candidiasis in critically ill populations generally [6,10].
Objective: We compared outcomes among adults with WHO-defined severe dengue managed with antifungal prophylaxis added to standard supportive care against standard care alone.
Methods: This retrospective comparative cohort analysis of ICU-admitted adults with severe dengue assessed cumulative incidence of proven or probable invasive fungal infection, plus ICU stay, ventilation duration, and mortality [5,21].
Findings: Invasive fungal infection incidence was lower with prophylaxis, concentrated in candidal disease, with shorter ICU stay and ventilation duration and lower fungal-attributable mortality; mould disease remained rare but disproportionately severe in both arms [20,14,11].
Conclusions: Targeted antifungal prophylaxis in severe dengue patients with recognized ICU risk factors was associated with a lower burden of invasive fungal infection, extending a principle from non-neutropenic critical care; prospective randomized confirmation is needed before routine use [19,22].
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