A 42-year-old Thai woman had a 1-year history of moving pain involving the entire body and a 1-month history of exacerbating right hypochondrial pain. Chest computed tomography showed multiple cavitary lesions and nodules in segment 6 of the right lung, and she was hospitalized on suspicion of pulmonary tuberculosis. However, she had a habit of eating raw meats, such as crab, frog, and others. Blood testing showed eosinophilia and elevation of serum IgE levels. Based on a positive reaction against Paragonimus westermani on microplate enzyme-linked immunosorbent assay (ELISA), P. westermani infection was diagnosed. Treatment with praziquantel proved effective, but the thin-walled cavitary lesions showed expansion after initiating treatment. Previous reports have described reduction or disappearance of cavities after treatment, but this case showed a different clinical course. Because left cavitary lesions have a possibility of chronic respiratory tract infection, careful follow-up should be required.