口服甲硝唑致黑色舌苔伴舌面溃烂

1例29岁女性患者因拔牙术后防治口腔感染服用甲硝唑0．4g，3次／d。第2天出现舌苔变黑伴舌面溃烂，停药并用口腔溃疡散涂患处。第3天，黑色舌苔逐渐呈块状脱落，伴有疼痛感。第4天黑色舌苔完全脱落，溃烂面基本愈合。间隔2d后患者因牙周肿痛再次自行服用甲硝唑0．4g，2次／d。用药第2天再次出现舌苔变色。停用甲硝唑，改为口服阿莫西林0．5g，3次／d，并给予氯芬待因止痛。2d后患者舌面恢复正常。

Black coated tongue with ulcer on the lingual surface induced by oral metronidazole

A 29-year-old woman received metronidazole 0.4 g thrice daily after tooth extraction for prevention and treatment of oral infection. The next day, she developed black coated tongue with ulcer on the lingual surface, metronidazole was discontinued and oral ulcer powder was applied to her affected region. On day 3, the black coated tongue showed lump-like desquamation gradually with pain. On day 4, the black coated tongue desquamated completely and her ulcer has healed. Two days later, the patient self-medicated with metronidazole 0. 4 g twice daily for pain and swelling of the gum. The next day of drug therapy, her tongue experienced discoloration again. Metronidazole was stopped and switched to amoxicillin 0.5 g thrice daily, she was given diclofenae sodium codeine phosphate to relieve pain. Two days later, the patient＇s tongue returned to normal.