halzoun (Marrara in Sudan)

Etiology: - Linguatula serrata Epidemiology: - common in the Middle East (especially Sudan) following ingestion of incysted larvae in raw liver or lymph nodes of sheep & goats Pathology: - larvae migrate to the nasopharynx to produce a self-limiting syndrome Clinical manifestations: 1) pain & itching of the throat & ears 2) coughing 3) hoarseness 4) dysphagia 5) dyspnea 6) copious nasal discharge 7) nausea/vomiting Laboratory: - larvae 5-10 mm in size may be found in nasal discharge or vomitus Complications: 1) severe edema may cause obstruction & necessitate tracheostomy 2) ocular invasion has been described

References

Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 936