Black brown discoloration and hairy tongue - A rare linezolid side effect.
Linezolid was approved for clinical use for methicillin resistant Staphylococcus aureus and vancomycin-resistant Enterococci. Additionally it is used in the management of drug resistant tuberculosis. It is well-tolerated however bone marrow suppression and neuropathies may occur in patients taking this antibiotic for more than 2 weeks. Black discoloration and black hairy tongue (BHT) due to linezolid is rarely reported. We report two cases of BHT.



Two patients of drug resistant pulmonary tuberculosis developed benign hairy tongue with linezolid 600mg per day. In both the cases black colored/hairy tongue was reported within 2-3 weeks of linezolid treatment. Both patients improved after withdrawal of linezolid. Subsequent reintroduction of linezolid with good oral hygiene was well tolerated and both patients completed the treatment of 2 years duration without any recurrence.



Black discoloration and BHT is a rare but transient adverse reaction with linezolid. Reintroduction of linezolid with good oral hygiene is well tolerated.
Senior Consultant National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India. Electronic address: akjain62@gmail.com.
A K
AK
Jain
Chest Physician (SAG), National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
Man Mohan
MM
Puri
Director, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
R
R
Sarin
D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D000069349:Linezolid / Q000009:adverse effects*; D008297:Male; D014064:Tongue, Hairy / Q000139:chemically induced / Q000175:diagnosis*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents; D000069349:Linezolid
Black discoloration of tongue; Black hairy tongue; Linezolid; MDR-TB; XDR-TB