# Black Hairy Tongue Associated With Linezolid Treatment for Olecranon Bursitis Due to Streptococcus salivarius and Streptococcus mitis

## TL;DR

A 63-year-old woman developed a rare side effect, black hairy tongue, while taking linezolid for a bacterial elbow infection but recovered after completing the treatment.

## Contribution

This case highlights that linezolid-induced black hairy tongue can resolve without immediate drug discontinuation.

## Key findings

- The patient recovered from bursitis and black hairy tongue after completing linezolid treatment.
- Immediate withdrawal of linezolid is not necessary for black hairy tongue resolution.
- Shared decision-making is important to avoid early discontinuation of the antibiotic.

## Abstract

A 63-year-old female presented with acute, atraumatic posterior elbow pain. She was found to have infectious olecranon bursitis with resistant bacteria. Her treatment was complicated by a penicillin allergy, necessitating the use of linezolid, which was further complicated by the rare black hairy tongue (BHT) side effect of linezolid. Despite the visible discoloration and associated pain from BHT, the patient continued linezolid to treat her bursal infection. She recovered from the bursitis and linezolid side effects after completion, supporting that immediate withdrawal is not necessary for the resolution of BHT but should be part of shared decision-making to avoid early discontinuation of the antimicrobial.