A Thai woman with lung lesions and her daughter with lung and brain lesions, both with a history of consuming raw freshwater crabs, were admitted to our institution. Based on the detection of worm eggs in the mothers' sputum by serum enzyme immunoassay/DNA sequence analysis, both mother and daughter were diagnosed as having Paragonimus westermani infection (triploids). Praziquantel treatment resulted in the normalization of blood eosinophil counts and eosinophil cationic proteins. Although the total IgE and various specific IgE antibodies were elevated in both the mother and daughter, no increases were detected in their urinary levels of leukotriene E4.