Here we present a case of a 37-year-old soldier of Indian Army, posted in high altitude area of Ladakh region (>4200 m), who after rejoining after a month leave, presented with dry cough, low-grade fever and dyspnoea on exertion while undergoing acclimatisation, and on examination, was detected to have hypoxaemia, fever and bilateral fine crepitations on chest auscultation. He was started on treatment for high altitude pulmonary oedema at a medical aid post, and later referred to General Hospital at Leh. The course of the illness was complicated by worsening hypoxaemia, continuous high-grade fever, leucopenia and hypotension. Focused medical history revealed that he had travelled to the state of Gujarat during his leave, where high incidence of H1N1 influenza was being reported during the ongoing pandemic. Oseltamivir was empirically started, in addition to parenteral antibiotics and he was started on inotropic support. In view of severe hypoxaemia, not responding to non-invasive ventilation, he was intubated and placed on mechanical ventilation. The patient turned out to be H1N1 positive and succumbed to his illness 3 days later.

The genus Candida consists of several species, including the Auris species, a pathogen that quickly colonizes and spreads on hospital surfaces and causes invasive fungal infections even after regular disinfection. It is very potent as it is resistant to several antifungals like the Echinocandins and azoles, commonly used to treat invasive fungal infections. Due to this, there is a global threat to public health. Auris could also spread as a Nosocomial infection through contaminated arm-pit thermometers that will increase the spread and dissemination of C. Auris, to seek protection against which, these multi use devices used on several patients should be cleaned carefully. In patients hospitalized with COVID-19, systemic fungal co-infections have been very common, which may increase the severity of the disease and be detrimental to the treatment process, and may also prove fatal. COVID-19 infection suppresses the patients' immunity. The attenuated CD80 upregulation of monocytes can explain and abolish the release of IL6, TNF, IL1a, and IL1b against Candida species making the patient more susceptible to secondary co-infections. The similarity between Covid and Candidiasis is that both emerge suddenly and spread astonishingly quickly, which cannot be easily comprehended by the traditional epidemiological analysis. The dry biofilms formed in C. Auris protect the microbe from complete removal due to robust cleaning. It was also found that C. Auris particles were obtained from patients with chronic respiratory disease using genome sequencing and multilocus microsatellite genotyping. In the timeline of April to July 2020, two-thirds of the COVID cases affected by candidemia admitted in the Intensive Care Unit in New Delhi were due to C. Auris, and the mortality rate was around 60%.