A 37-year-old man presented with low-grade fever, persistent headache, and night sweats for a month duration. He had no smoking history and oral hygiene was good. Chest CT showed multiple nodules. Magnetic resonance imaging (MRI) of the brain showed multiple low-density lesions and small abscesses with surrounding edema. The sputum and cerebrospinal fluid GeneXpert MTB/RIF assay indicated positive and further culture proved TB infection. The patient was diagnosed with pulmonary tuberculosis with tuberculous meningitis. He was treated with isoniazid, rifampicin, pyrazinamide, ethambutol, and linezolid 600 mg daily in combination with steroids, and the patient's headache relieved within two weeks. Brain MRI was repeated after 4 weeks, which showed decreased abscesses and absorbed edema. However, after 28 days of the above anti-tuberculosis treatment, the patient experienced abnormal taste and tongue black discoloration (Figure 1C). Tongue swab culture showed Klebsiella pneumoniae. Upon cessation of linezolid for 15 days, his tongue returned to normal. The patient later met the criteria to be cured of tuberculosis.