Lingua Villosa Nigra in a 3 Month Old Infant Following Antibiotic Exposure: A Case Report at Chawama Mini Hospital in Chingola.

Abstract

Background: Lingua villosa nigra (LVN), or black hairy tongue, is a benign condition caused by elongation and discoloration of the filiform papillae. While common in adults, LVN is extremely rare in infants and can cause diagnostic uncertainty. Antibiotic-induced disruption of the oral microbiota is a recognized risk factor, but few cases have been reported in children under six months.
Case Presentation: We report a 3 month old male with persistent black discoloration of the dorsal tongue following antibiotic treatment for staphylococcal scalded skin syndrome. The lesion was initially misdiagnosed as oral candidiasis and treated with nystatin, without improvement. Examination revealed black, elongated filiform papillae on the dorsal tongue and no systemic illness. A diagnosis of lingua villosa nigra was made, and conservative management with gentle tongue brushing was started.
Outcome: The patient showed progressive improvement, with near-complete resolution in three weeks and full resolution within two months.
Conclusion: Greater awareness of lingua villosa nigra in infants is essential to prevent misdiagnosis and unnecessary antifungal therapy. Conservative oral hygiene remains the standard treatment.