The Marrara syndrome: a hypersensitivity reaction of the upper respiratory tract and buccopharyngeal mucosa to nymphs of Linguatula serrata

Abstract

The Marrara syndrome, like Halazoun in Lebanon, is a hypersensitivity reaction of the upper respiratory tract and buccopharyngeal mucosa to nymphs of Linguatula serrata. The condition follows the consumption of Marrara which consists of raw liver, lungs, trachea and rumen of goats and sheep infected with larvae L. serrata. The adult worm is found in the nasal passages of dogs. Sheep and goats are infected by eggs from infected dogs. A survey that included 240 adult individuals in a village of endemic L. serrata infection in the Sudan showed that 20% experienced symptoms of allergic nasopharyngitis (Marrara syndrome) following the consumption of raw viscera of goats or sheep at least once in their life. In a prospective study of 24 patients who reported to hospital with the Marrara syndrome, the clinical features included itching in the throat and nose, unilateral conductive deafness, tinnitus and facial palsy. Secondary bacterial infection caused suppurative otitis media. Adult L. serrata parasites were found in the nasal passages of 56 and 47% of male and female dogs in the endemic area. Nymphs were recovered from the mesenteric lymph nodes, lungs and livers of goats in the area.