Presence of Klebsiella Pneumoniae on Black Hairy Tongue as Oral Microbiome Dysbiosis

Authors

  • Reiska Kumala Bakti Specialist Program of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya - Indonesia
  • I Gusti Agung Sri Pradnyani Specialist Program of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya - Indonesia
  • Ajiravudh Subarnbhesaj Department of Oral Biomedical Science. Division of Oral Diagnosis. Faculty of Dentistry. Khon Kaen University, Khon Khaen - Thailand
  • Desiana Radithia Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya - Indonesia

DOI:

https://doi.org/10.46862/interdental.v21i2.12176

Keywords:

Oral dysbiosis, Black hairy tongue, Microbiology, Lifestyle

Abstract

Introduction: Black hairy tongue (BHT) is a benign condition characterized by discoloration and elongation of filiform papillae. Although asymptomatic, it can trap microorganisms, potentially contributing to oral dysbiosis. The pathogenesis is still unclear, but smoking, drugs, alcohol, or excessive coffee/tea consumption trigger it. Diagnosis relies on history-taking, clinical assessment, and occasionally microscopic evaluation. This case report aims to show an interesting finding in the microbiological examination of black hairy tongue.

Case: A 33-year-old male smoker and coffee drinker presented with black tongue discoloration. Any medication use and a history of systemic diseases are denied, but he had a habit of smoking, staying up late, and heavy coffee consumption.

Case Management: Clinical assessment and microbiological swab analysis for bacterial and fungal identification were conducted. Microbiological examination revealed the presence of Klebsiella pneumoniae, a colonizing opportunistic pathogen.

Discussion: The patient reported no systemic diseases or medication use, with lifestyle factors identified as potential triggers. This case underscores the role of lifestyle factors and oral hygiene in the development of BHT and its association with microbial dysbiosis.

Conclusion: The detection of K. pneumoniae emphasizes the need for microbial evaluation in persistent cases to prevent potential systemic effects.

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References

1. Gurvits GE, Tan A. Black hairy tongue syndrome. World J Gastroenterol 2014; 20(31): 10845-10850. Doi:10.3748/wjg.v20.i31.10845

2. Unal O, Turker AH, Akcam FZ. A case report of black hairy tongue (melanotrichia linguae or lingua pilosa nigra). Cureus 2024; 16(Iv): 14-17. Doi:10.7759/cureus.60685

3. Shangguan Y, Ji Z, Guo W, Hu W, Li X, Xu K. Oral bacteria dysbiosis in patients with linezolid-induced black hairy tongue: A case series. Infect Drug Resist. 2022; 15(1): 5449-5454. Doi:10.2147/IDR.S373266

4. Schlager E, St. Claire C, Ashack K, Khachemoune A. Black hairy tongue: Predisposing factors, diagnosis, and treatment. Am J Clin Dermatol 2017; 18(4): 563-569. Doi:10.1007/s40257-017-0268-y

5. Maier T. Oral microbiome in health and disease: Maintaining a healthy, balanced ecosystem and reversing dysbiosis. Microorganisms 2023; 11(6): 11-14. Doi:10.3390/microorganisms11061453

6. Grine G, Royer A, Terrer E, Diallo OO, Drancourt M, Aboudharam G. Tobacco smoking affects the salivary gram-positive bacterial population. Front Public Heal 2019; 7(1): 1-6. Doi:10.3389/fpubh.2019.00196

7. Riedel S, Morse SA, Mietzner T, Miller S. Jawetz, Melnick & Adelberg’s Medical Microbiology. (28th, ed.). New York: McGrawHill; 2019.

8. Saifi S, Ashraf A, Hasan GM, Shamsi A, Hassan MI. Insights into the preventive actions of natural compounds against Klebsiella pneumoniae infections and drug resistance. Fitoterapia 2024;173:105811. Doi:https://doi.org/10.1016/j.fitote.2023.105811

9. Liu J, Spencer N, Utter DR, et al. Persistent enrichment of multidrug resistant Klebsiella in oral and nasal communities during long-term starvation. bioRxiv Prepr 2023; 12(1): 1-34. Doi:https://doi.org/10.1101%2F2023.12.18.572173

10. Corrin B, Nicholson AG. Chapter 5 - Infectious diseases. In: Corrin B, Nicholson AG, eds. Pathology of the Lungs (Third Edition). Third Edit. Edinburgh: Churchill Livingstone; 2011.p.155-262. Doi:https://doi.org/10.1016/B978-0-7020-3369-8.00005-7

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Published

2025-08-05

How to Cite

1.
Bakti RK, Pradnyani IGAS, Subarnbhesaj A, Radithia D. Presence of Klebsiella Pneumoniae on Black Hairy Tongue as Oral Microbiome Dysbiosis. interdental [Internet]. 2025 Aug. 5 [cited 2025 Aug. 8];21(2):331-4. Available from: https://e-journal.unmas.ac.id/index.php/interdental/article/view/12176