Rare consequence of taking antibiotics: patient overgrown black hair on the tongue

Rare consequence of taking antibiotics: patient overgrown black hair on the tongue

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After the accident, black hair grows on the patient's tongue

After a 55-year-old woman was involved in a serious car accident and recovered in a hospital, the patient began to complain of nausea and bad taste in her mouth. The subsequent examination of the mouth showed that the patient's tongue had turned black. But it got worse, the tongue was covered with hair-like structures.

In a woman, hair-like structures on the tongue developed after a car accident. Such a rare case of a hairy black tongue is due to an illness known as lingua villosa nigra. The doctors have now published the case report of this unusual disease in the English-language journal "New England Journal of Medicine".

How was the woman treated after her accident?

After a serious injury in which both legs of the patient were crushed, the woman affected had to be hospitalized. During recovery, one of her injuries developed an infection. The medical team put her on antibiotic therapy with meropenem, which she received intravenously, and minocycline, which was administered orally.

Treatment led to strange tongue disease

A week later, the patient's tongue began to turn brownish-black in color. She complained of nausea and reported bad taste in her mouth. The doctors diagnosed that she had a black hairy tongue, with a reaction to minocycline as a possible cause, explains the report's author, Professor David Warren of the Washington University School of Medicine. Such a hairy tongue is a benign and surprisingly common condition, but most of the time it appears yellowish, and not black, as in this particular case.

Why does the disease occur?

In the United States alone, about one percent of the population is affected by this condition, and in some parts of the world up to 10 percent of people have the condition. The disease occurs when the bumps on the top of the tongue, the so-called filiform papillae, become unusually long. These small pimples usually have a length of 1 millimeter to 18 millimeters. From a biological point of view, black hair doesn't really grow on the tongue. If you look closely at the surface of the tongue, you can see that it looks like sandpaper. The filiform papillae form the rough surface. Usually this outer layer of the papillae is rubbed off continuously while eating. With a hairy tongue, however, this layer grows faster for various reasons and the papillae become longer and longer despite the abrasion.

Changes in the types of bacteria that normally live in the mouth can cause the symptoms to develop. Antibiotics and medications have also been mentioned as possible triggers. Smoking, poor oral hygiene, the consumption of black tea, the consumption of coffee and radiation for head and neck tumors can also have an impact on the development. Fortunately, a black hairy tongue is reversible and has no long-term health effects.

How is the disease treated?

A hairy black tongue can be very worrying, but is generally benign, experts say. Some people with hairy black tongues report irritation in the mouth, bad taste in the mouth, bad tasting food or bad breath. Treating the hairy tongue includes avoiding certain foods and beverages in the diet that are known to cause the disease. In addition, those affected should give up smoking and pay attention to better oral hygiene. Gently brushing the tip of the tongue with a soft toothbrush can also help. If these steps do not work, those affected should consult their doctor, the doctors recommend. In the current case, the minocycline was discontinued in women and replaced by another group of antibiotics. The patient was also advised to pay attention to better oral hygiene. Her tongue returned to normal four weeks after stopping minocycline. (as)

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