{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:17:39Z","timestamp":1789186659308,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T00:00:00Z","timestamp":1757203200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Black hairy tongue (BHT), or lingua villosa nigra, is a rare adverse effect of linezolid, an antibiotic frequently used in the treatment of multidrug\u2010resistant tuberculosis (MDR\u2010TB). We present a case of a 24\u2010year\u2010old female who developed BHT while receiving linezolid as part of a longer regimen for MDR\u2010TB. The patient exhibited a typical BHT presentation, with painless brown\u2010to\u2010black discoloration on the posterior dorsal surface of her tongue, appearing 25\u2009days after initiating linezolid therapy. There were no other identifiable contributing factors. Upon discontinuation of linezolid and a shift to a modified regimen, the BHT completely resolved within 10\u2009days. A Naranjo Adverse Drug Reaction Probability Scale score of 5 suggested a probable causal relationship between linezolid and BHT. This report represents the first documented case of linezolid\u2010associated BHT from Nepal, highlighting the importance of clinicians' awareness of this rare but clinically significant side effect, especially within the context of MDR\u2010TB treatment, to provide prompt diagnosis, reassurance, and appropriate management.<\/jats:p>","DOI":"10.1002\/ccr3.70868","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T04:00:51Z","timestamp":1757304051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Black Hairy Tongue as a Rare Adverse Effect of Linezolid in Multidrug\u2010Resistant Tuberculosis: A Case Report"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0525-1330","authenticated-orcid":false,"given":"Dipendra","family":"Adhikari","sequence":"first","affiliation":[{"name":"Tuberculosis Treatment Center  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salina","family":"Paudel","sequence":"additional","affiliation":[{"name":"Tuberculosis Treatment Center  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munna","family":"William","sequence":"additional","affiliation":[{"name":"Nishtar Hospital  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj Kumar","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Dadeldhura Hospital  Dadeldhura Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanju","family":"Dahal","sequence":"additional","affiliation":[{"name":"Shree Birendra Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abishkar","family":"Gautam","sequence":"additional","affiliation":[{"name":"Tuberculosis Treatment Center  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binay","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Tuberculosis Treatment Center  Pokhara Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,7]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"\u201c1.3 Drug\u2010Resistant TB \u201daccessed March 22 2025 https:\/\/www.who.int\/teams\/global\u2010tuberculosis\u2010programme\/tb\u2010reports\/global\u2010tuberculosis\u2010report\u20102024\/tb\u2010disease\u2010burden\/1\u20103\u2010drug\u2010resistant\u2010tb."},{"key":"e_1_2_12_3_1","volume-title":"WHO Consolidated Guidelines on Tuberculosis: Module 4: Treatment \u2010 Drug\u2010Susceptible Tuberculosis Treatment","author":"World Health Organization","year":"2022"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2024.1338902"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096\u2010002\u20100753\u2010x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/CLPT.1981.154"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/IJDD.IJDD_48_20"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060520961279"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i31.10845"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.23750\/ABM.V89I3.7060"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/prm2.12083"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.29245\/2689\u20109981\/2023\/1.1170"},{"key":"e_1_2_12_13_1","unstructured":"WHO \u201cWHO Consolidated Guidelines on Tuberculosis \u201d(2022) WHO Consolidated Guidelines on Tuberculosis: Module 4: Treatment \u2010 Drug\u2010Resistant Tuberculosis Treatment 2022 Update accessed August 16 2025 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK588564\/."},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMOA0800106"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.70868","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T03:55:16Z","timestamp":1759204516000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.70868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":13,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/ccr3.70868"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.70868","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-04-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70868"}}