A 23-Year-Old Man Is Brought to the Emergency Department from a College

A 23-year-old man is brought to the emergency department from a college party because of a 1-hour history of a crawling sensation under his skin. He appears anxious and is markedly pale. His temperature is 38°C (100.4°F) , pulse is 104/min, respirations are 18/min, and blood pressure is 145/90 mm Hg. Physical examination shows diaphoretic skin, moist mucous membranes, and dilated pupils. His speech is loud, rapid, and difficult to interrupt. Which of the following is the most likely diagnosis?

A) Anticholinergic toxicity
B) Bipolar disorder, manic episode
C) Cocaine intoxication
D) Delusional disorder, persecutory type
E) Opioid withdrawal
F) Phencyclidine intoxication
G) Schizophreniform disorder