Black Hairy Tongue

Area of Science:

• Medicine
• Pharmacology
• Dermatology

Background:

• Cellulitis and abscesses are common bacterial infections.
• Piperacillin-tazobactam is a broad-spectrum antibiotic frequently used for serious infections.
• Black hairy tongue (BHT) is a benign, temporary oral condition with various potential causes.

Purpose of the Study:

• To report a case of black hairy tongue (BHT) potentially induced by piperacillin-tazobactam therapy.
• To describe the clinical presentation and management of this adverse drug reaction.

Main Methods:

• A 65-year-old male patient with type 2 diabetes mellitus and left lower-limb cellulitis was treated with intravenous piperacillin-tazobactam.
• The patient developed a dark discoloration of the tongue during antibiotic treatment.
• Diagnosis of BHT was made, the antibiotic was discontinued, and oral hygiene measures were advised.

Main Results:

• The patient presented with symptoms of cellulitis and impending abscess, with co-existing type 2 diabetes mellitus and acute kidney injury.
• Piperacillin-tazobactam was initiated, and wound debridement was performed.
• On day 6, the patient developed BHT, characterized by a dark coating on the dorsal tongue.
• Following antibiotic cessation and improved oral hygiene, the BHT resolved within one week.

Conclusions:

• Piperacillin-tazobactam may be an iatrogenic cause of black hairy tongue (BHT).
• Good oral hygiene and discontinuation of the offending agent are effective management strategies for drug-induced BHT.
• Healthcare providers should be aware of this potential adverse effect when prescribing piperacillin-tazobactam.