Abstract
This case highlights a young female in her early twenties who presented with fever and persistent dry cough of one week duration. After ruling out other conditions she was subsequently diagnosed as Mycoplasma pneumonia. It is one of the important causes of atypical pneumonia. The manifestations can range from mild upper respiratory tract infections to severe pulmonary and extra-pulmonary manifestations. The patient's clinical course was complicated by systemic immune activation, which manifested as elevated inflammatory markers, radiological and clinical worsening and development of autoimmune hemolytic anemia. Prompt identification and management with appropriate antimicrobials and other supportive therapy along with timely use of steroid led to steady clinical improvement. This case underlines the importance of considering atypical pathogens in febrile respiratory illnesses and the vigilance for early recognition of systemic immune phase complications.