Q. A 58-year-old woman has been brought to the emergency department by her husband for high fever with chills and severe right ear pain since yesterday. She is a known case of rheumatoid arthritis for more than 15 years and is on regular check-ups with her rheumatologist. Her medical history shows that she had multiple admissions to the hospital for pneumonia and UTI in the past 3 years. The most recent hospital discharge summary from a year ago shows that she was admitted for sepsis secondary to bilateral community-acquired pneumonia. She got treated with doxycycline and cefuroxime, but the course was complicated by neutropenia which was later managed with a granulocyte colony-stimulating factor. She is a diabetic and is on regular insulin. Her temperature is 102°F (38.8°C), pulse is 110 beats per minute, blood pressure is 130/86 mm of Hg and respiratory rate is 16 per minute. Physical examination shows injected tympanic membrane on the right side and pharyngeal erythema. Abdominal examination is notable for tender splenomegaly. Lungs and heart examinations are normal. Laboratory investigations are shown below. Peripheral blood smear shows no significant abnormalities with normal reticulocytes. What is the most likely diagnosis for this patient based on her clinical history and findings?