Adverse reaction report and retrospective analysis of black hairy tongue caused by linezolid

Abstract

The adverse reaction of Black Hairy Tongue (BHT) caused by linezolid is rare. We reports a case of linezolid-induced BHT, and reviews relevant literatures at home and abroad. It aims to provide a safe and reasonable basis for clinical medication use. A 14-year-old adolescent with pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) developed a rash and pruritus due to Vancomycin. Instead, the patient was given linezolid 600mg q12h in injection during hospitalization and in tablet after discharge. On the 14th day after injection and the second day after oral administration the patient showed BHT without other abnormal taste symptoms. But all the symptoms could be tolerated and he completed the therapy course of linezolid. Tongue symptoms completely disappeared on the 8th day after drug withdrawal. Based on the Karch and Lasagna evaluation methods and the cause-and-effect evaluation methods of the WHO collaborating center for international adverse drug reaction (ADR) monitoring, it is likely that this patient had a BHT caused by linezolid. The mean time of occurrence of BHT was 14.36 days, and the mean time of symptom disappearance was 23.43 days after drug administration. When linezolid is prescribed to patients, especially those with atopy, the patient's tongue should be closely observed and good oral hygiene is recommended.

Hairy Tongue and Associated Risk Factors among Outpatients in Faculty Dentistry of Damascus University: A Cross-Sectional Study

“…In our study there is a true statistically significant correlation between smoking and the hairy tongue infection, smoking leads to estimated prevalence of 75% in hairy tongue patients. [16][17][18][19][20][21][22][23][24][25] In contrast to several studies linking hairy tongue with smoking , there are some articles that do not confirm such high rates, they reported that the casual smoking poses a slightly increased risk of having BHT compared to non-smokers (15% to 10% in men, 5.5% to 5.2% in women). As a result all studies believed that smoking was a predisposing factor to trigger excess production of keratin and discoloration of the keratin.26-29 Our results show a significant relationship between HT and excess consumption of black tea and coffee which was similar to that in Prabha's study.30 However, other studies confirmed such a relationship.…”

Oral Bacteria Dysbiosis in Patients with Linezolid-Induced Black Hairy Tongue: A Case Series

“…15 Cases of linezolid-induced BHT commonly suffer from poor appetite and loss of taste. Tongue discoloration occurs in nearly two week or long-term use of linezolid and can be resolved 2-3 weeks after linezolid discontinuation, 6 but the BHT may recur after reintroduction of linezolid. 16 However, little is known about the alterations in oral bacteria on the black tongue and the correlation between these changes and the occurrence of the black tongue.…”

“…4,5 Black hairy tongue (BHT) is also a rare adverse effect associated with Linezolid. 6,7 BHT is characterized by pigmentation of the dorsal tongue which appears black, or green or yellow, and may be accompanied by hypertrophy of the filiform papillae. [8][9][10] The prevalence of black hairy tongue varies highly in the general population ranging from 0.6% to 11.3% and is significantly higher in males.…”

Linezolid‐induced black hairy tongue in a child following osteomyelitis

“…3 However, a literature review from 2020 found that six out of 14 linezolid-induced BHT cases were pediatric cases; this suggests that linezolid-induced BHT occurs even in pediatric patients. 4 antibiotics were used in our patient, BHT usually occurs 10-15 days after administration. 4 Linezolid was therefore the most likely cause.…”

“…4 antibiotics were used in our patient, BHT usually occurs 10-15 days after administration. 4 Linezolid was therefore the most likely cause. The exact mechanisms of BHT are unknown, though altered oral microbial flora and overgrowth of chromogenic microorganisms have been proposed as possible causes because some antibiotics have been known to cause BHT.…”