An acute fibrile illness is one of the major diagnostic and treatment challenges for clinicians to recognize the concurrent co-infection with multiple pathogens in many parts of India and the Asia Pacific region. Originally, the diagnosis was on the basis of clinical syndrome by a single pathogenic virus, which is initially isolated from specimen that would be the final approach of treatment. However, clinical reports suggested many vector borne viruses, but cases of mixed infection with dengue-orientia tsutsugamushi are distinctly limited and few were reported. This mixed infection case of dengue and scrub typhus was reported with abdominal pain, fever, headache, arthralgia, high pulse rate, altered blood count picture, and lowered platelet count. Normal range of hemoglobin, significant thrombocytopenia, lower systolic blood pressure, normal leucocyte counts, altered liver enzymes, and low serum albumin. Clinical score on the basis of febrile illness with continuous surveillance of deranged laboratory parameters is needed to accurately establish the presence of co-infections, which can offer timely treatment along with appropriate control measures that many reduce the rate of morbidity and mortality.