A 42-year-old lady underwent open reduction and internal fixation for a fracture of the right humerus. She was prescribed oral linezolid 600 mg twice daily and noticed asymptomatic, black discolouration of the tongue on day 4 [Figure 1]. The black hairy tongue or lingua villosa nigra is reported as a rare self-limiting adverse effect of linezolid and is seen in 0.2% of the patients receiving linezolid. The exact mechanism is unclear but could be due to the elongation of the filiform papillae and the overgrowth of chromogenic bacteria and yeast on the dorsal surface of the tongue. Poor oral hygiene is also a risk factor and may have contributed to its development in our case. No specific treatment is required and it resolves spontaneously, as was noted in our case.

Figure 1:: Blackish discolouration with prominent filiform papillae over the dorsum of the tongue

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