Saudi Journal of Pathology and Microbiology (SJPM)
Volume-3 | Issue-10 | 394-397
Case Report
The Black Hairy Tongue: CANDIDA OR NOT?
Khermach A, Er-rami M
Published : Oct. 30, 2018
Abstract
The Black Hairy Tongue (BHT) is characterized by a hypertrophy of
lingual papillae in the posterior part of the back of the tongue which often take a
brown to black coloration; its etiology is unknown but probably multifactorial:
alcohol-smoking, poor hygiene prolonged use of antiseptics or oral antibiotics,
digestive and metabolic disorders, etc. We report two observations of BHT where the
diagnosis of candida was retained following the detection on several samples of the
same species and the good clinical evolution under suitable antifungals. P atient aged
53 years, having as antecedent pathological a taking of cortico therapy for an eczema
problem in the feet, the port of dentures with bad oral hygiene that presents itself for a
brownish color in the tongue with no functional discomfort, no feeling of impasto or
itching. The patient was put under Flagyl, canaflucan and protected amoxicillin
without clinical improvement. Microbiological examination was performed, direct
examination after culture showed the presence of yeasts. The culture on Sabouraud
medium made it possible to isolate a candida. The identification using the gallery 20
C AUX objectified candida glabrata. The patient is put under Nystatin with a good
clinical and biological evolution. P atient 67 years old, diabetic, chronic smoking,
checked up for heart failure under stent, with dentures and excessive hygiene of the
oral cavity. The one whounderwent a dermatological consultation for brownish
coloring of the tongue, the diagnosis of BHT is retained. The mycological study
confirmed the diagnosis of candida lusitaniae. The patient was put on nystatin tablet
with good clinical progress. The purpose of our work was not to highlight a causal
link between candida and the occurrence of this pathology but its incrimination in the
process or maintenance of this lesion.