Question category: Psychiatry
An elderly man is on the ward due to a left sided pneumonia. He becomes acutely distressed and punches a nurse. His notes state that he drinks 4 pints of beer a day. On examination his temperature is 38.1 C, BP is 110/60 mmHg, pulse is 95/min and regular, there is consolidation at his left lung base, his white cell count is raised significantly and renal function is impaired. What has caused his symptoms?