The speaker recounts two dreams, starting with the more recent one. In it, a woman dressed in "worms and whispers" appears, a figure of decay and rumor. The speaker circles her once, then slinks off on all fours, as if fear has stripped away anything human. The night before, a smirking "minor lord of the underworld" casually explained that the dead take the living down with them, since that's how they get a taste of eternal youth. His grin is compared to a candied skull, sweet and deadly at once, which fits the title's mix of sugar and rot.
The ending is a sudden shift. Awake, the speaker calls the dreams "melodramatic" and writes one yellow word in the snow, probably by urinating, though the poem only hints at it. The gesture feels like shrugging off the fear with a joke, yet the cold, bare image keeps the unease around. The mood is eerie, darkly funny, and a little defiant.