Woman Develops "Black Hairy Tongue" After Taking Medication

A 55-year-old patient who was recovering in a hospital after getting into a motorcycle crash that severely crushed her legs suddenly found herself with another problem after her tongue began turning black.

The case report, published in the New England Journal of Medicine, said the patient began complaining of nausea and a bad taste in her mouth after being given intravenous meropenem and oral minocycline antibiotics to help fight bacteria in her body. 

“Black hairy tongue, resulting from treatment with minocycline, was suspected,” the case report authors wrote. “Black hairy tongue is a benign condition characterized by hypertrophy and elongation of filiform papillae on the surface of the tongue, with brownish-black discoloration.”

The temporary condition can also be caused by poor oral hygiene, use of tobacco, or irritating mouthwashes and antibiotic agents. The condition gives the tongue a black discoloration, which can also be green or white, as well as a furry appearance. Symptoms often include a metallic taste in the mouth, bad breath, and tickling sensations. 

Doctors prescribed the patient a different antibiotic and advised her to practice good oral hygiene. According to the report, doctors say the patient's tongue returned to normal within four weeks. 

Photo: New England Journal of Medicine