Mycoplasma pneumonia may be a ubiquitous respiratory bacterium that causes community acquired pneumonia and other respiratory illness . Neurological sequelae occur in up to 7% of patients with M pneumonia infections and include meningoencephalitis, inflammatory neuropathies and transverse myelitis. Different immune mechanisms may account for this heterogeneity. It appears that Mycoplasma Associated Meningitis (MAM) either occurs early, possibly thanks to bacterial invasion of the CNS or late secondary to a suspected post-infectious immune phenomenon. We present a case of early M pneumonia meningitis and myelitis that did not show clinical improvement with directed antimicrobial therapy but skilled corticosteroids. A 24 year old Aboriginal male presented to a rural hospital in New South Wales, Australia with 24 hours of fever (39.3°C), frontal headache, neck pain, vomiting and photophobia. The patient denied recent travel or intravenous drug use and wasn't immunosuppressed. He had an upper tract infection four days before presentation.