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An 82-year-old man with Alzheimer disease diagnosed four years ago lives in residential care, where he usually plays cards each afternoon and needs help only with dressing. Over the past two days staff report that he is drowsy each morning, frightened and shouting by early evening, plucks at the bedclothes, and cannot follow a two-step instruction that he managed on Monday. He began trimethoprim for a urinary tract infection yesterday, and his temperature is 37.8°C. Which one of the following best explains the change in him?
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