A systematic random sample of 267 patients who were involved in outpatient detoxification was surveyed. Their records were evaluated, and the demographics, psychiatric diagnoses, and type(s) of substance of abuse of each patient were recorded. The results indicated that there was a significant relationship between an anxiety disorder and whether the patient was addicted to an opioid. A followup was conducted on 79 patients who were addicted to an opioid, and had an anxiety diagnosis. Of this group, 54 (70%) responded, of which only 22 (40%) said that they were receiving some type of treatment for their disorder. All of these patients reported that they were sober and that their anxiety disorder significantly decreased.

We report a case of pulmonary strongyloidiasis in a patient with large granular lymphocytosis. He was on short-term high dose immunosuppressant therapy. A 77-year-old white male presented to the emergency room with fever and shortness of breath for 10 days. The patient had been diagnosed about 3 months prior to this presentation with “large granular lymphocytosis” (LGL) after a workup for pancytopenia. Methotrexate and prednisone had been started 1 month ago for the treatment of LGL. Five days prior to the current presentation, he had been started on moxifloxacin as an outpatient but got progressively worse and came to an emergency room. Bronchial washings (bronchoalveolar lavage) demonstrated numerous filariform larvae of Strongyloides stercoralis. The patient was treated with ivermectin and improved. Pulmonary strongyloidiasis should be considered in the differential if X-ray findings show a interstitial or alveolar pattern and if the patient has visited the endemic areas, even in the remote past.

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