While Performing the Otoscopic Examination of a 3-Year-Old Boy Who

While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear,the nurse finds that his left tympanic membrane is bright red and the light reflex is not visible.The most likely cause is:

A) fungal infection.
B) acute otitis media.
C) rupture of the drum.
D) blood behind the drum.