Review Question - QID 214505

A 27-year-old man presents to the emergency department after being brought in for belligerent behavior. The patient was at a bonfire party in the desert during the summer in Arizona. He attempted to assault law enforcement when they arrived. The patient's past medical history is otherwise unknown. His temperature is 99.3°F (37.4°C), blood pressure is 132/88 mmHg, pulse is 107/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam is notable for a belligerent young man who is given intramuscular olanzapine. The patient is unkempt and smells of urine. Cardiopulmonary exam reveals bilateral coarse breath sounds. Inspection of the patient's lower extremity reveals 2 paired vertical/parallel lacerations which are actively oozing serosanguinous fluid with swelling, erythema, and edema extending from the marks up to the patient's midcalf. Palpation of the lower extremity causes the patient to grimace. Which of the following is the most likely etiology of this patient's symptoms?