Reactions Weekly | 2021
Multiple drugs
Abstract
Hairy tongue and xerostomia: case report A 55-year-old man developed a hairy tongue during treatment with ciprofloxacin, cotrimoxazole, quetiapine and piperacillin/ tazobactam, and developed xerostomia during treatment with quetiapine [indications, routes, dosages and duration of treatments to reaction onsets not stated; not all outcomes stated]. The man developed a new, hair-like coating on his tongue after treated for a month in the ICU for Guillain-Barre syndrome. He was intubated for about 11 days and had undergone a tracheostomy. He was distressed due to his tongue appearance and had a concern about a decreased sense of taste. His smoking history was consistent with 30 pack/year. During ICU admission, he received piperacillin/tazobactam, cotrimoxazole [trimethoprim/sulfamethoxazole], ciprofloxacin and quetiapine. Initially, he was diagnosed with oral candidiasis and treated with several courses of oral nystatin and systemic fluconazole without improvement. Also, the change in his colour coating of the tongue was observed after he switched from tube feeds to oral intake, and fluconazole to ciprofloxacin. In view of his history, typical clinical appearance and no response to antifungal medication, he was diagnosed with ciprofloxacin, cotrimoxazole, quetiapine and piperacillin/tazobactam-related hairy tongue, and quetiapine-related xerostomia. Two months later, the man’s hairy tongue improved substantially.