Adhikari Dipendra, Paudel Salina, William Munna, Bhatt Manoj Kumar, Dahal Sanju, Gautam Abishkar, Adhikari Binay
Tuberculosis Treatment Center Pokhara Nepal.
Nishtar Hospital Multan Pakistan.
Clin Case Rep. 2025 Sep 7;13(9):e70868. doi: 10.1002/ccr3.70868. eCollection 2025 Sep.
Black hairy tongue (BHT), or lingua villosa nigra, is a rare adverse effect of linezolid, an antibiotic frequently used in the treatment of multidrug-resistant tuberculosis (MDR-TB). We present a case of a 24-year-old female who developed BHT while receiving linezolid as part of a longer regimen for MDR-TB. The patient exhibited a typical BHT presentation, with painless brown-to-black discoloration on the posterior dorsal surface of her tongue, appearing 25 days after initiating linezolid therapy. There were no other identifiable contributing factors. Upon discontinuation of linezolid and a shift to a modified regimen, the BHT completely resolved within 10 days. A Naranjo Adverse Drug Reaction Probability Scale score of 5 suggested a probable causal relationship between linezolid and BHT. This report represents the first documented case of linezolid-associated BHT from Nepal, highlighting the importance of clinicians' awareness of this rare but clinically significant side effect, especially within the context of MDR-TB treatment, to provide prompt diagnosis, reassurance, and appropriate management.
黑毛舌（BHT），又称黑绒毛舌，是利奈唑胺一种常用于治疗耐多药结核病（MDR-TB）的抗生素罕见的不良反应。我们报告一例24岁女性病例，该患者在接受利奈唑胺作为耐多药结核病更长疗程治疗方案一部分时出现了黑毛舌。患者表现出典型的黑毛舌症状，舌背后面无痛性棕黑色变色，在开始利奈唑胺治疗25天后出现。没有其他可识别的促成因素。停用利奈唑胺并改用改良方案后，黑毛舌在10天内完全消退。Naranjo药物不良反应概率量表评分为5，表明利奈唑胺与黑毛舌之间可能存在因果关系。本报告是尼泊尔首例记录在案的利奈唑胺相关性黑毛舌病例，强调了临床医生认识到这种罕见但具有临床意义的副作用的重要性，特别是在耐多药结核病治疗的背景下，以便及时诊断、给予安心和适当管理。
