A 20-year-old Hispanic male prisoner presented with a chronic foot infection. Six years earlier, he had been in a flood during a hurricane in Oaxaca, Mexico. Soon afterward, he experienced pain in his left foot but denied injury. Within 2 years, a sinus tract developed on the plantar surface of his left foot. Three years later, nodules, swelling, and further sinus tract formation also occurred. The patient was incarcerated in the United States during the following year and was referred by the prison to our clinic.