Fig. 2

The patient's pathological section, bacterial culture, postoperative endoscopy and eye motility Fig. A HE staining of the mastoid granulation of the left middle ear suggested chronic inflammation of local mucosa with neutrophil infiltration. Scale bar = 20 μm. B PAS staining of the pathological section of the mastoid granulation of the left middle ear indicated a small amount of yeast-like fungi in the exudate of the middle ear (blue arrow), accompanied by budding phenomenon, and the morphology suggested yeast infection. Scale bar = 20 μm. Image A and B were obtained using the EasyScanner (Motic, Xiamen, China) and its associated software (Motic DSAssistant Plus, Motic). C Bacterial culture of secretion from left ear suggested near smooth yeast, CHROMagar candida chromogenic medium,72 h, creamy colorless smooth colony. D Bacterial culture of the secretion from the left ear was seen under the microscope (× 1000 times). Gram staining was positive and swarms of ovoid spores were seen. E Overall view of mastoid cavity and external auditory meatus under endoscopy after operation. F White punctate secretions of external auditory canal were observed under endoscopy. G mNGS showed candida tropicalis. H The patient had limited abduction and adduction of the left eye