Review Question - QID 214504

A 24-year-old man with a history of depression presents to the emergency department with nausea, vomiting, and confusion. The patient went on a camping trip with his friends where they foraged and caught their own food and cooked it. At the end of the hike, the patient had an episode of abdominal pain, nausea, and vomiting. This episode resolved, and the patient felt better the next day. However, the patient was subsequently found by his girlfriend the next day profoundly confused with discoloration of his skin early the next morning. The patient is otherwise healthy, is a vegetarian, and exercises regularly. His temperature is 99.2°F (37.3°C), blood pressure is 100/65 mmHg, pulse is 122/min, respirations are 26/min, and oxygen saturation is 100% on room air. Physical exam is notable for a somnolent man with yellowing of his skin. There are old healed scars on his wrists. Initial laboratory values are notable for an ALT of 1,772 U/L and an AST of 1,599 U/L. Which of the following is the most likely etiology of this patient's symptoms?