Do You Recognize This Triad?

25-year-old male presents to the emergency department with headache, retro-orbital pain, and diplopia when gazing to the right. He had visited an urgent care clinic with right ear pain two weeks earlier and had received a short course of antibiotics. After some initial improvement, he became increasingly unwell before presenting today. Otoscopy reveals purulent discharge in the right ear canal and a CT scan demonstrates the findings seen here. Which organism is most commonly responsible for this patient’s likely diagnosis?

A. Streptococcus pneumoniae
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Aspergillus fumigatus

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