Today, the expansion of international and local travel, recreational activities, eco-tourism, animal transportation together with effects of global warming and migration of birds have resulted in vector borne diseases emerging as global threats. Non-availability of rapid diagnostic tests for most neglected tropical vector borne diseases has added to the clinical challenge in both the resource poor tropics as well as in the developed world. Until such time, as effective early diagnostic methods are available, the most important aspect in the management of such illnesses is the vigilance of clinicians. It is crucial to formulate the most likely differential diagnosis based on the clinical presentation of acute undifferentiated febrile illness and the epidemiological data. In order to achieve this goal, attention paid to the chronology of events such as progression of the symptoms or appearance of signs such as skin rash plays a vital role. Here we aim to highlight the unusual clinical presentation of this patient and the importance of the late onset skin rash that alerted the physicians to the possible diagnosis of SFGR.