The case concerns a patient with eosinophilic meningitis attributed to the helminthic parasite Angiostrongylus cantonensis. Before the onset of illness, our patient had a history of travel to Hawaii, the only area in the United States where A cantonensis is endemic. Finding eosinophils in the cerebrospinal fluid (CSF) can narrow the differential diagnosis in a patient with meningitis. In our patient, the proportion of eosinophils in the CSF was 55%. The case is unique because the patient was a strict vegetarian. This infection usually develops in persons who inadvertently ingest snails or slugs that contain the parasite. [Infect Med. 2008;25:366-368]
