Review Question - QID 212745

A 33-year-old man presents to the emergency department with altered mental status. He was at work as a construction worker when his coworkers found him down at the work site. The patient recently underwent anesthesia for an appendectomy several months ago. He also has a past medical history of schizophrenia well controlled with haloperidol and is currently taking phenytoin for epilepsy. He is also currently taking propranolol for anxiety and hyperthyroidism. His temperature is 106°F (41.1°C), blood pressure is 109/62 mmHg, pulse is 170/min, respirations are 23/min, and oxygen saturation is 95% on room air. Physical exam is notable for an altered man with a Glasgow Coma Scale of 10. He has minimal muscle tone and is incoherent when answering questions. The patient is covered in sweat and dirt. Which of the following is the most likely diagnosis?