We present a sporadic case of SFGR infection from coastal belt of Sri Lanka who presented with an acute febrile illness and polyarthritis complicated with acute kidney injury and DIC. She probably developed early PF in the form of wide spread ‘fern-leaf’ pattern necrotic skin rash with evidence of vasculitis on the palms and soles and DIC on the 10th day of illness. We feel that clinicians should be aware of this unusual clinical presentation that could occur in association with SFGR infection. Such knowledge would not only benefit those who practice in tropics with limited diagnostic facilities but also would improve the management of acute febrile illness in returning travelers who visit endemic areas.