A 22-year-old university undergraduate presented with persistent fever and appearance of rash on the 4th day of illness. On the 3rd day, he consulted his general practitioner (GP) who detected thrombocytopenia. The dengue duo test (dengue NS1 antigen, IgM and IgG) was negative. Concerned after the rash appeared, the patient sought consultation at the Emergency Department (ED) in a local hospital and was admitted. Investigations in hospital confirmed chikungunya infection. This case report highlights two key messages in the American Centers for Disease Control and Prevention (CDC) advisory: (1) it is difficult to distinguish chikungunya and dengue based on clinical findings alone; (2) the patient should be managed as having dengue until dengue has been excluded.