A 38-year-old Hispanic man with a 3-month history of presumed fungal keratitis in the right eye was referred to our facility for further management. Initially, the patient presented with a small corneal infiltrate in the peripheral aspect of the right cornea to an outside ophthalmologist who had obtained a bacterial culture and placed the patient on 2 fortified topical antibiotics. After 1 week of aggressive antibiotic treatment with negative culture results, the patient's symptoms of redness and photophobia had deteriorated arid the referring doctor noted 2 additional satellite lesions. The patient was placed on topical natamycin 5.0%. After1 week of treatment with natamycin, the satellite lesions were reported to have resolved with some improvement in the patient's subjective symptoms of redness and pain; however, the area of initial infiltrate had enlarged and the other symptoms had not improved. The patient was then referred to our facility.
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