Clinical diagnostic characteristics of linezolid-induced black hairy tongue
Wang Hao1, Ming Qianwen2, Wang Bin3, Lu Taikun1, Zhang Haining1.
1Department of Neurology and Neuroscience Center, 3Department of Teaching, the First Bethune Hospital of Jilin University, Changchun 130021, China; 2Department of Radiology, Second Xiangya Hospital, Central South University, Changsha 410011, China
Abstract:ObjectiveTo investigate the clinical diagnostic characteristics of linezolid-induced black hairy tongue. MethodsThe clinical data of a patient with black hairy tongue after linezolid treatment in the Department of Neurology, the First Bethune Hospital of Jilin University on September 26, 2020 were retrospectively analyzed. Additionally, relevant literature was reviewed to analyze the possible mechanism, clinical diagnostic characteristics, and prevention and treatment strategies of linezolid-induced black hairy tongue. ResultsA 37-year-old female patient was admitted to the hospital for 1 week due to symptoms of headache, fever, nausea, and vomiting. Her diagnosis was bacterial meningitis (tuberculosis could not be ruled out). The patient was prescribed linezolid in combination with anti-tuberculosis medication. After 18 days of linezolid treatment, the dorsum of her tongue turned black, and visible hair-like alterations emerged after 23 days. Thirty days after stopping linezolid, the black tongue covering on the dorsum of the tongue vanished, so did the odd sensation in the oral cavity. Combined with the relevant literature, the median appearance time of black hairy tongue after taking linezolid was 14.0 (12.0,21.0) days, while the average disappearance time of black hairy tongue after quitting linezolid was (13.4±6.6) days. Black hairy tongue was characterized by the extension and hypertrophy of the filiform papillae, as well as brown or black staining on the posterior dorsum of the tongue. On the assumption of excluding microbiological infection, the diagnosis of black hairy tongue relied on visual observation, and it would subside following drug withdrawal and the elimination of risk factors. ConclusionsBlack hairy tongue may be associated with the use of the linezolid. Clinically, the diagnosis can be made by the elongation and hypertrophy of the filiform papillae and the brown or black discoloration of the dorsum of the tongue.
王昊1明倩文2王斌3卢太坤1张海宁1. 利奈唑胺致黑毛舌的临床诊断学特征[J]. 中华诊断学电子杂志, 2023, 11(4): 254-260.
Wang Hao1, Ming Qianwen2, Wang Bin3, Lu Taikun1, Zhang Haining1.. Clinical diagnostic characteristics of linezolid-induced black hairy tongue. zhzdx, 2023, 11(4): 254-260.
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