A 45-year-old female patient comes to the emergency department complaining of severe ear pain and discharge from her right ear. She reports having a history of recurrent otitis media in childhood. On examination, the patient has a temperature of 38.5°C and there is tenderness on palpation of the tragus. There is also a significant amount of purulent discharge from the right ear. What is the most likely diagnosis?

A. Acute mastoiditis

B. Acute otitis externa

C. Cholesteatoma

D. Serous otitis media

E. Acute otitis media

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