A 54-year-old male with medical history of hypertension was admitted for inability to walk and painless leg swelling. The swelling started in both feet and progressively extended to his mid legs. There was no swelling in any other parts of his body. Patient had been walking barefoot for about 10 years prior to presentation, after he became homeless. He lives under a bridge in Atlanta and walks around dirt frequently. He denied travelling outside Georgia. On examination, he had significant non pitting edema up to the knees bilaterally.
