Headache is a common clinical complaint mostly with a self-limited course but may also be a symp-tom of central nervous system infection. If the diagnosis is not established in time, permanent neu-rological deficits and even death may occur. We presented a 43-year-old man who had fever and per-sistent dull pain in the top of the head as symptoms for a month before admission, especially the most severe headache when waking up in the morning. The headache got worsened, diplopia and bilateral lower extremities numbness were noticed one week before admission. Despite several visits to a local clinic, no definite diagnosis was made. On admission, the patient was conscious. However, he was un-able to rotate his right eye internally. The brain images showed no abnormality. A cerebrospinal fluid examination suggested that the lymphocytic meningitis and serum eosinophils levels were higher than expected. After a thorough medical history inquiry, we found out that the patient ate raw frogs five days before the headache was occurred. Enzyme-linked immunosorbent assays identified antibodies to Angiostrongylus cantonensis in his cerebrospinal fluid and serum. Eosinophilic meningitis caused by Angiostrongylus cantonensis was therefore diagnosed. The patient recovered smoothly after a four-month treatment with a minor sequelae symptom remaining. This case reminds us that when encoun-tering lymphocytic meningitis and the proportion of eosinophils in serum or cerebrospinal fluid is abnormally high, it is necessary to take the initiative to inquire about the dietary history to determine whether there are ingested parasites potential from contaminated food and drinking water.
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