Black hairy tongue recurrence after antibiotic therapy with various agents: A susceptibility of unknown mechanism?

Abstract

Introduction: Black hairy tongue consists in the hypertrophy and elongation of the lingual papillae which implies a change of colour in the tongue dorsum surface. The underlying mechanisms are not well understood, to date has been linked with antibiotic use among other causative agents but there is a lack of strong evidence in this correlation.

Clinical case: A 61-year-old woman presented a black hairy tongue in the postoperative days following an endolaryngeal microsurgery. By that time, she had just started the intake of amoxicillin-clavulanic acid. Reinterrogating the patient, she had a previous episode after the intake of clarithromycin years before.

Discussion: The case exposed supports the role of antibiotics as trigger of black hairy tongue and furthermore establishes the first case reported to date with clarithromycin as trigger. The fact that our patient presented two episodes triggered with two different antibiotics might be explained by an individual susceptibility not described to date.