Black‐brown hairy tongue: An unusual adverse effect of linezolid

Abstract

Linezolid‐induced black hairy tongue (BHT) is an uncommon side effect. We present a case of linezolid induced BHT and evaluate relevant literature from the home and worldwide. Its goal is to offer a secure and appropriate foundation for clinical drug usage. A 23‐year‐old male with recurrent boil infection erroneously reported by gram‐positive methicillin‐resistant Staphylococcus aureus (MRSA) by pus culture, which was misdiagnosed by a small clinic (diagnostic center) in a rural region of Bangladesh where he had previously been treated for that reoccurring boil infection. The patient was actually suffering from a different pus‐forming bacteria (Klebsiella), a gram‐negative bacterium that was just found after careful C/S report. Linezolid was administered to the patient 600 mg q12h orally in tablet after discharge from that rural clinic. On the 14th day following oral treatment, the patient presented to the hospital with BHT but no other atypical taste complaints. However, all symptoms were tolerable, and he finished the linezolid treatment period. After withdrawing from the medicine, all tongue symptoms vanished. Following a thorough study, it was determined that this patient had BHT brought on by drug linezolid. Long‐term linezolid usage is associated with neuropathies and bone marrow suppression. There is, however, little information about an uncommon adverse effect, black hairy tongue. We present here a case of linezolid induced BHT in a patient who was misdiagnosed. Also covered are the etiology, pathophysiology, diagnosis, and management of black hairy tongue.