Hairy Tongue Induced by Piperacillin-Tazobactam

A 65-year-old male, diagnosed with Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic (VEXAS) syndrome and extended-spectrum beta-lactamase Escherichia coli urosepsis, was initiated on intravenous piperacillin-tazobactam.After 1 week of antibiotic therapy, he developed black discolouration of the tongue.On examination, the dorsum of the tongue showed black, elongated filiform papillae with a characteristic carpet-like appearance [Figure 1].A clinical diagnosis of antibiotic-induced black hairy tongue was made, and the patient was advised to maintain proper oral hygiene.