Review Question - QID 212590

A 25-year-old man presents to the emergency department with altered mental status. The patient has not been feeling well since yesterday, and this morning his roommate found him unarousable. The patient is generally healthy and is a college athlete. He recently broke his nose in a soccer game, and it is currently healing with only gauze in his nose to stop occasional bleeding. He otherwise has no significant medical history. His temperature is 102°F (38.9°C), blood pressure is 87/58 mmHg, pulse is 130/min, respirations are 24/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding in Figure A. Which of the following is the most likely diagnosis?